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Increasing Mobility via In‐hospital Ambulation Protocol Delivered by Mobility Technicians: A Pilot Randomized Controlled Trial
Author(s) -
Hamilton Aaron C,
Lee Natalie,
Stilphen Mary,
Hu Bo,
Schramm Sarah,
Frost Frederick,
Fox Jacqueline,
Rothberg Michael B
Publication year - 2019
Publication title -
journal of hospital medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.128
H-Index - 65
eISSN - 1553-5606
pISSN - 1553-5592
DOI - 10.12788/jhm.3153
Subject(s) - medicine , randomized controlled trial , protocol (science) , hospital medicine , medline , physical therapy , alternative medicine , family medicine , surgery , pathology , political science , law
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.