Physical dependence and urinary catheters both strongly relate to physical inactivity in adults during hospital stay: a cross-sectional, observational study

Sven J. G. Geelen, Boukje M. Giele, Cindy Veenhof, Frans Nollet, Raoul H. H. Engelbert, Marike van der Schaaf

Research output: Contribution to journalArticleAcademicpeer-review


To determine which factors are associated with physical inactivity in hospitalized adults of all ages.

A cross-sectional sample of 114 adults admitted to a gastrointestinal surgery, internal medicine or cardiology hospital ward (median age 60, length of stay 13 days) were observed during one random day from 8 am to 8 pm using wireless accelerometers and behavioral mapping protocols. Factors (e.g., comorbidities, self-efficacy, independence in mobility, functional restraints) were collected from medical records, surveys, and observations.

Patients were physically active for median(IQR) 26 (13–52.3) min and were observed to lie in bed for 67.3%, sit for 25.2%, stand for 2.5%, and walk for 5.0% of the time. Multivariable regression analysis revealed that physical inactivity was 159.87% (CI = 89.84; 255.73) higher in patients dependent in basic mobility, and 58.88% (CI = 10.08; 129.33) higher in patients with a urinary catheter (adjusted R2 = 0.52). The fit of our multivariable regression analysis did not improve after adding hospital ward to the analysis (p > 0.05).

Independence in mobility and urine catheter presence are two important factors associated with physical inactivity in hospitalized adults of all ages, and these associations do not differ between hospital wards. Routine assessments of both factors may therefore help to identify physically inactive patients throughout the hospital.

Healthcare professionals should be aware that physical inactivity during hospital stay may result into functional decline.

Regardless of which hospital ward patients are admitted to, once patients require assistance in basic mobility or have a urinary catheter they are at risk of physical inactivity during hospital stay.

Implementing routine assessments on the independence of basic mobility and urine catheter presence may therefore assist healthcare professionals in identifying physically inactive patients before they experience functional decline.
Original languageEnglish
Pages (from-to)6684-6691
JournalDisability and rehabilitation
Issue number22
Early online date2021
Publication statusPublished - 2022


  • behavioral mapping
  • exercise
  • factors
  • hospital
  • mobility
  • physical activity

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