4. Discussion
COPD, Pitta
COPD, CHRONIC OBSTRUCTIVE PULMONARY DISEASE
This study evaluated the effectiveness of Hospital Fit in addition to usual care physiotherapy on enhancing the PA behavior of hospitalized patients. It was hypothesized that patients who used Hospital Fit would spend more time walking per day than patients that received usual care physiotherapy without using Hospital Fit. Moreover, an increase in time spent standing per day, time spent upright per day, and an increase in the number of daily postural transitions from a sedentary to an active position were expected with Hospital Fit use. Although patients who used Hospital Fit spent more time standing and walking and interrupted their sedentary behavior more often compared to patients that received usual care physiotherapy without using Hospital Fit, the effects were not significantly different between the groups, even after correcting for the influence of functional independence.The hypothesis that Hospital Fit use results in an increase in PA behavior of hospitalized patients was based on a previous study that demonstrated an average increase of 28.4 min (95% CI: 5.6–51.3) standing/walking on POD1 after the introduction of Hospital Fit to the usual care physiotherapy in patients following orthopedic surgery [On day five and six, the largest effects were seen. When corrected for functional independence, patients who used Hospital Fit spent on average 27.4 min (95% CI: −2.4–57.3) more standing and walking on day five and 29.2 min (95% CI: −6.4–64.7) more on day six than patients who did not use Hospital Fit. Although these results are not significant, they are comparable to the results found in the previous study investigating Hospital Fit in orthopedic patients [The PA behavior of patients included in the current study was comparable to other studies. Pitta et al. showed that patients admitted for an exacerbation of Chronic Obstructive Pulmonary Disease (COPD) spent a median time of 50.4 (IQR 21.6–133.9) minutes upright on day two and 64.8 (IQR 50.4–151.2) minutes on day seven of hospitalization [