Impact of a Hospital Mobility Program on Function After Discharge
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 132
- 试验地点
- 4
- 主要终点
- Life-Space Assessment Score
研究概览
简要总结
After hospitalization, many older adults experience more difficulty getting around in the community and performing one or more of their basic activities of daily living (ADLs) like bathing or dressing. The goals of this study are to test the effectiveness of a mobility intervention, compared to usual care, on change in mobility after hospitalization, to determine the impact on one-year outcomes such as nursing home placement and to identify which Veterans benefit the most from the intervention. Ultimately, the goal is to improve recovery after hospitalization and reduce disability in hospitalized Veterans.
详细描述
For this high impact study the investigators propose to use a stepped wedge cluster randomization design on five VA hospital wards to compare a mobility program (MP) to usual care (UC) among a cohort of Veterans age 50 years. The investigators will examine pre to post-hospital mobility and adverse outcomes including functional decline, nursing home admission, emergency department (ED) visits, hospitalization and death in the MP and UC groups in the year after hospital discharge. The primary outcome of mobility will be measured by the University of Alabama at Birmingham (UAB) Life-Space Assessment (LSA).10-13 Secondary measures of mobility will include self-reported ability to walk mile and drive a car, as described by Gill, et al.14 The investigators will identify patient specific characteristics that modify the effect of the mobility intervention on post-hospital mobility and adverse outcomes to determine which hospitalized patients are most likely to benefit from this intervention.
Note, Secondary outcome measures were curtailed as the original PI, Dr. Brown, retired.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- Single (Outcomes Assessor)
入排标准
- 年龄范围
- 50 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Age 50 years admitted to one of the five hospital wards of the Birmingham VA Medical Center (VAMC) for any medical illness, e.g.:
- •Pneumonia
- •Heart failure
- •Chronic obstructive pulmonary disease (COPD) exacerbation
- •Or other medical (versus surgical) indication for hospitalization
- •Patients will be recruited within 48 hours of hospitalization, followed throughout their hospitalization and for one year after hospital discharge.
排除标准
- •Patients admitted for brief observation will be excluded, e.g.:
- •23-hour observation for possible myocardial infarction
- •Additional exclusion criteria will include:
- •Inability to walk across a small room 2 weeks prior to admission
- •Inability to walk safely with assistance, based on a strength and balance screen (see Training of Walkers, below for details)
- •Having a pulmonary embolus, unstable angina or other medical diagnosis deemed by the primary physician to be a contraindication to walking
- •Being on hospice or comfort care
- •Being in a semi-private room with another currently enrolled participant
- •Non-English speaking, blind, or deaf
结局指标
主要结局
Life-Space Assessment Score
时间窗: One year
The UAB Study of Aging Life-Space Assessment (LSA) is a validated tool that measures mobility and function based on the distance which a person reports moving during the four weeks preceding the assessment. The range in scores is 0-100 with higher scores representing better life space mobility.
次要结局
- Presence of Adverse Outcomes: Rehospitalization(One Year)
- Presence of Adverse Outcomes: Nursing Home Placement(One year)
- Instrumental Activities of Daily Living (IADLs)(One year)
- Activities of Daily Living (ADLs)(One Year)
- Presence of Adverse Outcomes: Death(One year)
- Confusion Assessment Method(Baseline only)
- Patient Health Questionnaire (PHQ) -2(One year)
- Presence of Adverse Outcomes (ED Visits, Rehospitalization, Nursing Home Placement, Death)(One year)
- Mini Cognitive Assessment (Mini-Cog)(Baseline only)
- EuroQOL Five Dimensions Questionnaire (EQ-5D)(One year)
- Lubben Social Network Scale (LSNS-Revised)(One year)
- Level of Hospital Mobility(Average one week)