Increasing Mobility via In‐hospital Ambulation Protocol Delivered by Mobility Technicians: A Pilot Randomized Controlled Trial. Issue 5 (20th February 2019)

• Record Type: Journal Article
• Authors: Hamilton, Aaron C; Lee, Natalie; Stilphen, Mary; Hu, Bo; Schramm, Sarah; Frost, Frederick; Fox, Jacqueline; Rothberg, Michael B
• Is Part Of: Journal of hospital medicine. Volume 14:Issue 5(2019)
• Page Start: 272
• Page End: 277
• Publication Date: 2019-02-20
• Subjects: Hospital care -- Periodicals; Clinical medicine -- Periodicals; 610
• DOI: 10.12788/jhm.3153
• Languages: English
• ISSNs: 1553-5592

Abstract

Abstract : BACKGROUND: Ambulating medical inpatients may improve outcomes, but this practice is often overlooked by nurses who have competing clinical duties. OBJECTIVE: This study aimed to assess the feasibility and effectiveness of dedicated mobility technician‐assisted ambulation in older inpatients. DESIGN: This study was a single‐blind randomized controlled trial. SETTING: Patients aged ≥60 years and admitted as medical inpatients to a tertiary care center were recruited. INTERVENTION: Patients were randomized into two groups to participate in the ambulation protocol administered by a dedicated mobility technician. Usual care patients were not seen by the mobility technician but were not otherwise restricted in their opportunity to ambulate. MEASUREMENTS: Primary outcomes were length of stay and discharge disposition. Secondary outcomes included change in mobility measured by six‐clicks score, daily steps measured by Fitbit, and 30‐day readmission. RESULTS: Control (n = 52) and intervention (n = 50) groups were not significantly different at baseline. Of patients randomized to the intervention group, 74% participated at least once. Although the intervention did not affect the primary outcomes, the intervention group took nearly 50% more steps than the control group ( P = .04). In the per protocol analysis, the six‐clicks score significantly increased ( P = .04). Patients achieving ≥400 steps were more likely to go home (71% vs 46%, P = .01). CONCLUSIONS: Attempted ambulation three times daily overseen by a dedicated mobility technician was feasible and increased the number of steps taken. A threshold of 400 steps was predictive of home discharge. Further studies are needed to establish the appropriate step goal and the effect of assisted ambulation on hospital outcomes.