2021, Article / Letter to editor (Journal of Physiotherapy, vol. 67, iss. 2, (2021), pp. 115-123)Question: What are the views of patients, close relatives and healthcare professionals on physical activity behaviour in hospital care? Methods: A meta-ethnographic synthesis of qualitative studies was conducted with a lines-of-argument analysis. The methodological quality of included studies was evaluated using the Critical Appraisal Skills Programme (CASP) checklist. The lines of argument were synthesised and mapped in an existing theoretical model. The confidence of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation Confidence in Evidence from Reviews of Qualitative Research (GRADE-CERQual) approach. Results: Eleven studies were included and provided data from 290 participants (145 patients, 0 close relatives and 145 healthcare professionals). We have synthesised six lines of argument that explained the (intention of) physical activity behaviour of patients during their hospital stay: patients and healthcare professionals perceive benefits and risks of physical activity for patients' health (high confidence); physical activity gives a sense of freedom, confidence in recovery and mental wellbeing (high confidence); all healthcare professionals should offer timely and tailored physical activity promotion (high confidence); patient motivation to be physically active may be contingent upon encouragement (moderate confidence); family members can influence physical activity behaviour favourably or unfavourably (low confidence); and hospital culture has a negative influence on physical activity behaviour of patients (high confidence). Conclusions: Physical activity behaviour of patients during their hospital stay is a complex phenomenon with multiple interactions at the level of patients, healthcare professionals and hospital culture. Considering the results of this synthesis, multifaceted implementation strategies are needed to improve physical activity intention and behaviour of patients during their hospital stay. (C) 2021 Australian Physiotherapy Association. Published by Elsevier B.V.
2021, Article / Letter to editor (Int J Environ Res Public Health, vol. 18, iss. 3, (2021))Low physical activity of patients is a global problem and associated with loss of strength and independent mobility. This study analyzes the effect of general physical activity promoting interventions on functional and hospital outcomes in patients hospitalized over 48 h. Five electronic databases were searched for randomized controlled trials. For outcomes reported in two studies or more, a meta-analysis was performed to test between-group differences (intervention versus control) using a random-effects model. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach was used to rate the certainty of evidence for each outcome. Out of 23,302 identified studies, we included four studies (in total n = 368 participants). We found with moderate certainty of evidence 0 reported falls in the intervention (n = 126) versus five reported falls in the control (n = 122), a non-statistically significant difference between intervention and control groups (p = 0.06). In addition, we found with (very) low certainty of evidence no statistically significant differences between groups on activities of daily living (ADL-activity) and time spent standing and walking. Overall, we found no conclusive evidence on the effect of general physical activity promoting interventions on functional outcomes. More research is needed to understand and improve the effect of general physical activity promoting interventions for patients during the hospital stay.