Study Highlights Barriers of Physical Activity in Hospitalized Patients

Sarasota, FL (WorkersCompensation.com) – A good outcome is critical to getting an injured worker back on the job. Lack of physical activity has a direct effect on outcomes of an injury or procedure. While the impact of low levels of activity have been well documented, some studies show that patients are inactive 87 to 100 percent of the time while inpatient, with only 70 minutes spent standing or walking. While the need for activity is well recognized, few studies have examined in depth the reason patients are reluctant to be physically active.

A recent study published in BMC took a closer look into why patients are not up and moving when clear evidence suggests they should be. Researchers from Amsterdam analyzed studies from numerous medical journals and categorized enablers and barriers to physical activity of patients, reviewing a total of 56 articles. Barrier criteria included aspects that reduced or negatively impacted patients attempts at activity. Enable criteria included aspects that improved or positively influenced patient’s attempts at activity. Patients reviewed included those that were in an acute care hospital setting, and reviewed healthcare workers were clinically active.

Barriers and enablers were self-reported, and categorized into 13 categories. The categories included factors such as knowledge, beliefs about capabilities, hospital and patient social environment.

The researchers found a total of 264 barriers reported by patients, and 415 barriers reported by healthcare workers. For the enabler category, 228 were reported by patients, and 409 reported by healthcare workers.

The most common barrier categories reported by patients included environmental and resources, social influences, and beliefs about consequences. Three times as many environmental barriers were reported, making it the top barrier category for patients. The most common barrier categories reported by healthcare workers included memory, attention decision processes, and social/professional role. The most common enabler categories from patients included social influences, and goals. The most common enabler category reported by healthcare workers included social influence, and behavioral regulation.

Considering that patients are taken out of their normal environment and faced often times with uncertainty, this study highlights the strong role that hospital environment and protocol can have in getting a patient active. Several studies have shown that a multidisciplinary mobility approach can improve physical function in patients. By incorporating graded physical activity, interesting walking destinations, measured hallways and marked trails, as well as incorporating exercise diaries, and extra supplies as needed, patient’s mobility can be improved.

The researchers believe that the study can assist clinicians in assessments so that specific factors can be targeted in intervention. 

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