Measurement of Physical Activity during General Inpatient Rehabilitation

Intervention group The study intervention is to implement changes in ward practices and culture to increase the physical activity of participants during inpatient rehabilitation. Interventions aimed at increasing participant’s physical activity on the rehabilitation ward. The interventions - specific frequency and components - are determined by the treating physiotherapist based on participant preference and level of physical function. The interventions will include, but not be limited to, current inpatient rehabilitation standard care plus having meals (breakfast, lunch and dinner) in a common dining room; walking a lap of the ward prior to attendance in the dining room or therapy gym; increased group therapy (balance, community access and gardening) during the week; and increased therapy on weekends (individual and group exercise sessions). Balance groups will occur three times a week, at least one of which will be in addition to the current exercise group and community access groups will occur weekly. Materials Participants who consent to participate in the study will have an activity monitor (ActivPAL micro) attached to their thigh with a water proof dressing, preferably on the less disabled lower limb. The activity monitor will be removed and reapplied weekly, so that data can be uploaded onto computer and the activity monitor can be recharged. This will be repeated until the participant has been discharged from inpatient rehabilitation. Rehabilitation/procedures/activities Participants will undergo rehabilitation. As a consequence, they may be involved in a number of activities delivered by a multidisciplinary team. Medical ward rounds, meals and activities (education sessions, games, Diversional Therapy) in the dining room, group therapy, individual therapy sessions delivered by allied health disciplines. Who will deliver the intervention All members of the rehabilitation team (medical, nursing and allied health) will deliver interventions that aim to increase each participant’s standing and walking time. For example, based on the level of physical function of participants as assessed by the treating physiotherapist, will be encouraged by staff to walk a lap of the ward prior to and following attendance in the dining room (for meals and/or education sessions) or the therapy room/gym. In addition, participant’s therapy schedule will be on a centralised timetable mounted on a wall (within the ward) that participants will be able to view by walking to view the timetable. This timetable will be completed by the rehabilitation team. Furthermore, additional groups will be run by physiotherapists, allied health assistants and /or occupational therapists such as - but not limited to - balance, community access, and gardening groups. Finally, therapy will also occur on weekends delivered by physiotherapists and/or physiotherapy assistants for approximately a total of 24 hours over the weekend. Mode of delivery Some therapy will occur in as individual sessions and others will be in the form of group therapy. Dosage/duration/intensity The intervention will occur during the participant’s inpatient rehabilitation admission. There will not be any specific dose, duration or intensity. Participants will be treated by physiotherapists and/or the physiotherapy assistant at least daily, often twice daily, in individual and/or group sessions. Location Inpatient rehabilitation ward