Abstract
In Volume 76, Supplement 1, of the American Journal of Occupational Therapy, I came upon the abstract by Kim et al. (2022) in which they summarized an objective measurement of physical activity level during rehabilitation times and days and compared various occupational therapy, physical therapy, and speech-language therapy interventions. Healthy People 2010 has described the physical activity of persons with disabilities (PWDs) with regard to meeting public health guidelines. Physical inactivity contributes to poorer health and quality of life overall (Kinne et al., 2004). I appreciate Kim et al.’s efforts to objectively measure the physical activity levels of inpatients during rehabilitation services, emphasizing active and sedentary times during rehabilitation and nonrehabilitation times and days. However, I wish to share my thoughts on their study.
First, more information about the participants’ demographic characteristics is needed. Apart from age and length of stay, information about whether each participant was ambulatory or a wheelchair user is important. Because the ActiGraph GT9X offers maximum wear position flexibility with modular accessories for wrist-, ankle-, waist-, or lumbar-worn devices, it may have made variable recordings for ambulatory persons versus wheelchair users. Thus, there could exist a bias between the physical activity levels between the two, resulting in diverse feedback. Surveys of PWDs have shown low self-reported physical activity levels, including leisure, aerobic exercise, and recreation, most of which are done by ambulatory populations. General population measurements can differ for wheelchair users because most focus on walking and mobile activities (Brown et al., 2005). Thus, variation in physical activities may exist, differentiating physically active and inactive people (Stotts, 1986).
Second, the reason why the total activity counts were higher in occupational therapy services than in physical therapy or speech-language therapy services could be because of patients’ involvement in other activities. These could include recreational or therapeutic group therapy sessions in which recreation or leisure was used as a means and ends to improve the quality of time use and activity engagement and to intensify rehabilitation in the form of therapeutic group sessions. Furthermore, leisure may involve lesser physical expenditure but higher degrees of satisfaction and improved quality of life (Paek et al., 2014).
Third, feedback from patients could have provided more elaborate information about their activity levels. One study explained that self-reported measures or feedback can provide insights into the nature, intensity, and duration of physical activities; many might not qualify or meet the public health guidelines for physical activity, each being different from the other (Warms et al., 2008). In addition, disability-appropriate measures or motion sensors with accelerometer technology may be more appropriate to assess and represent physical activity levels (Tudor-Locke & Myers, 2001).
Fourth, most patients prefer to spend time with family, which includes nonrehabilitation time. This also includes psychological support and the sharing of feelings, which contribute to the patient’s emotional needs. Favorable social and family support can have a significant impact on the progressive improvement of functional status and well-being (Tsouna-Hadjis et al., 2000). Thus, to enable patients to reach optimal well-being, family time should be given an importance equal to that of the therapy times.