Mapping physical, cognitive and social Activity in RehabilitatIOn (MARIO): Activity on the Acute Rehabilitation Unit (THS-S)

Mr Sam de Zoete1, Mr Brendon Bakes2, Ms Dawn Simpson1, Ms  MIchele Callisaya1

1Physiotherapy Department, Tasmanian Health Service South, Hobart, Australia, 2Acute Rehabilitation Unit, Royal Hobart Hospital, Hobart, Australia

Background: Emerging evidence suggests that enriched rehabilitation environments (physical, cognitive and social) enhance recovery and outcome by facilitating greater intensity and repetitions of practice. However, studies show that patients in rehabilitation are often alone and inactive for much of the day. We aimed to describe the activity of patients on the Acute Rehabilitation Unit (Royal Hobart Hospital) using behavioural mapping.

Methods: Data were collected according to a standardised procedure for one weekday (8.00am to 4.00pm). Patients were observed every 15 minutes by researchers who recorded the location, type, postural position, people present during the activity observed. We collected additional measures of diagnosis category (neurology, orthopaedic, medical, other), mobility status and age. Descriptive statistics were used to describe the percentage of time in each location, activity type and position.

Results: 17 of 18 ward patients were successfully observed.  Patients were categorised as: orthopaedic (n=4), neurological (n=11), medical (n=1), and surgical (n=1). Location: Patients were noted to spend 67% of time in bedroom and 11% of time in the therapy gym. People: Patients spent 36% of the audited time alone and 43% with staff. 10% of total time was spent with Physiotherapy. Activity: Patients were seen to be inactive 29% of time (8% of time sleeping), and 55% of time active (physical, social or cognitive). 16% of time was unobservable. Position: Patients spent 2.4% of time walking, 6 % of time walking, 44% of time sitting in a chair and 30% of time lying in bed.

Conclusions: Patients spent less time alone than reported as average in prior literature. However, the data suggests patients spent large portions of their day inactive and confined to their rooms. This information will be used by the ward to drive discussion and strategies on ways activity may be increased in the future.


Sam de Zoete is the senior Physiotherapist on the Acute Rehabilitation Unit at the Royal Hobart Hospital. Over the past 15 years he has worked in various Physiotherapy roles throughout Australia from urban Melbourne to remote Arnhem Land. Whilst in this position, Sam has participated in both research and numerous quality improvement projects aimed at reaching the ever elusive: an enriched oasis of rehabilitation within the walls of a nebulous tertiary hospital

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