Measuring Physical Activity in Hospital Settings: A Scoping Review of Randomized Controlled Trials

Objectives: To identify physical activity and sedentary behavior outcomes, measurement tools and protocols used, and data integrity in randomized controlled trials (RCTs) of hospital-based movement interventions in middle-aged and older adults. Design: Scoping review of RCTs. Setting and Participants: Adults with a mean or median age ≥50 years admitted to an acute or subacute hospital. Methods: Four databases were searched for RCTs published between 2000 and 2023 evaluating interventions and measuring outcomes related to movement behavior (physical activity and/or sedentary behavior) of adults during an acute or subacute inpatient admission. Data extracted included movement behavior outcomes, measurement tools/devices, measurement protocols, and the integrity of movement data. Data were reported and synthesized using frequencies/percentages and via narrative summaries. Results: After screening (n = 18,018), 34 studies were included. Most studies were conducted in subacute rehabilitation (n = 13) and excluded participants with cognitive impairment (n = 27) and/or mobility impairment (n = 24). A total of 17 different movement behavior outcomes were measured, with step count measured in 22 studies. Most studies (n = 30) measured movement behaviors using a wearable device. There were 43 unique measurement devices/tools used across studies, with significant heterogeneity observed in protocols for their use. Conclusions and Implications: Given the substantial heterogeneity of movement behavior outcomes, and measurement tools and protocols used, there is an urgent need to develop evidence-based guidelines for measuring movement behaviors in hospital-based trials. Without this, synthesis of clinical trial outcomes and subsequent implementation of effective interventions for improving hospital-based movement behaviors will remain lacking.