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Thought Leader Session

Guidelines Session

Aging Adult Track

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Research Snapshot Theater: Behavioral Health and Well-Being, Adult and Pediatric

Social Barriers to Physical Activity Engagement After Critical Illness

Tuesday, March 24, 2026

8:45 AM - 9:45 AM Central Time

Location: Connections Central - RST 12

Lindsey Fresenko, PT, DPT, PhD (she/her/hers)

University of Toledo Medical Center, Ohio

Disclosure(s): No relevant financial relationship(s) to disclose.
FG

Felipe Gonzalez-Seguel, PT, MSc

Doctoral candidate
University of Kentucky

Disclosure information not submitted.
LS

Louisa A. Summers, Ph.D.

Clinical Research Coordinator
University of Kentucky

Disclosure information not submitted.
JA

Jadyn Adams, N/A

Undergraduate Research Trainee
University of Kentucky

Disclosure information not submitted.
JL

Julianne Lush, N/A

Undergraduate Research Trainee
University of Kentucky

Disclosure information not submitted.
SS

Stacey Slone, MS

Statistician
University of Kentucky

Disclosure information not submitted.
Anna G. Kalema, MD

University of Kentucky College of Medicine, Kentucky

Disclosure information not submitted.
AM

Ashley Montgomery-yates, MD, FCCM

Senior Vice Chair of Internal Medicine
University of Kentucky, Kentucky

Disclosure information not submitted.
Peter Morris, MD

University of Alabama at Birmingham, Alabama

Disclosure information not submitted.
DL

Douglas Long, M.S.

Senior Research Associate
University of Kentucky

Disclosure information not submitted.
RH

Rachel Hogg- Graham, DrPH, MA

Associate Professor
University of Kentucky

Disclosure information not submitted.
ED

Esther E. Dupont-Versteegden, PhD

PhD
Department of Physical Therapy, College of Health Sciences, University of Kentucky

Disclosure information not submitted.
Kirby P. Mayer, PhD, (he/him/his)

University of Kentucky, Kentucky

Disclosure information not submitted.

Introduction: Patients who survive critical illness often have functional impairments impacting their ability to engage in physical activity (PA). Previous studies have shown that in the first week after hospital discharge, survivors of critical illness achieved an average of 1300 steps per day. The factors related to lower PA engagement may be impacted by patient’s social determinants of health (SDOH). The purpose of this study is to identify patient characteristics and SDOH that influence PA during early recovery.

Methods: This prospective study enrolled patients who survived critical illness at the University of Kentucky Medical Intensive Care Unit (MICU). Patients were provided with activity trackers (Garmin VivoFit 4) to wear daily upon enrollment near hospital discharge (baseline). Steps per day were collected at baseline, 3- and 6-months after discharge. SDOH were examined with a validated questionnaire and self-reported activity was assessed with the International Physical Activity Questionnaire (IPAQ)) at the 6-month time point. Grouped t-tests, chi-square, repeated measures ANOVAs, and Spearman correlations were conducted for statistical analyses.

Results: Eighty-two patients were included in the study of which 53% were male with a median age of 60 (IQR 50-66) and a median BMI of 27.7 (IQR 22.9- 31.6). The average steps per day at baseline, 3 and 6 months were 3,963 (CI 1,736-9,049), 5,425 (CI 2,403-12,245) and 6,536 (CI 2,916-14,649) respectively. Baseline daily steps were significantly different from the 3-month t= 2.97, p= 0.004) and 6-month (t= 3.72, p< 0.001) time points after discharge. Based on the reported living situation, patients engaged in different quantities and levels of exertion during walking each week. (H= 6.17, p= 0.046) Patients with a higher BMI (r= -0.29, p=0.041) and a greater number of comorbidities (r= -0.33, p=0.019) were associated with less engagement in vigorous activity per the self-reported IPAQ.

Conclusions: Patients surviving critical illness engaged in less than the American Heart Association recommended amount of daily activity (7,000 steps per day) for cardiovascular health up to 6 months after discharge. Recognizing that patients’ preexisting health status and SDOH related to their PA engagement is crucial to improve patient recovery after critical illness.