Gamification to Increase Mobility in the Hospital
试验速览
- 阶段
- 不适用
- 状态
- 撤回
- 入组人数
- 150
- 试验地点
- 2
- 主要终点
- Change in mean daily step count during hospitalization
研究概览
简要总结
Low mobility is a mediator for poor outcomes of hospital care. Wearable devices will be used and 2-way texting via patient smartphones to monitor patients' physical activity during hospitalization with and without gamification to improve patient adherence to existing guidance on recommended activity. After discharge, investigators will assess patient care utilization (SNF, inpatient vs home rehab, ED visits, readmission) and conduct validated surveys on patient function at 30 days after discharge.
详细描述
Hospitalization is a common occurrence for older adults; approximately 6.8 million Medicare seniors experience an admission for acute care in any given year. This is often a sentinel event in the overall health trajectory of older adults that is complicated by functional impairment, Skilled Nursing Facility placement, and reduced mobility after discharge.
In the current paradigm, low mobility during hospitalization is largely viewed as a temporary inconvenience that should not affect overall functional ability or outcomes such nursing home placement and that patients should return to their previous activity level soon after they return home without lingering mobility changes. Recent research, however, suggests disruptions of basic activities of daily life such as mobility (getting out of bed and walking) may be "traumatic" or "toxic" to older adults with long-term post-hospital effects. What is lacked is precise data on how much immobility is noxious and how much mobility is needed to protect against adverse outcomes.
The primary objective is to assess the effectiveness of a gamification intervention to increase physical activity before hospital discharge. Investigators will explore patients' physical activity while in the hospital and if that differs across floors that have already deployed a nursing mobility protocol (Founders 10, 11, 12, 14). Investigators will also explore changes in patient functional status, SNF placement, and 30-day hospital readmission.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Health Services Research
- 盲法
- Triple (Participant, Investigator, 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
- •Admitted to a medicine or cardiology floor in the hospital
- •Age 50 years or older
- •Have an AMPAC (mobility scale) score of greater than or equal to 21 or a Braden mobility sub-scale score of 4.
排除标准
- •Inability to provide informed consent
- •Does not have daily access to a smartphone compatible with the wearable device and not willing to use a device that the study team can provide
- •Inpatient AMPAC score of less than 21 or a Braden mobility sub-scale score less than 4 indicating that independent physical activity may not be appropriate for the patient
- •Are already enrolled in another physical activity study
- •Any conditions that would prohibit participation in an inpatient physical activity program (at the discretion of attending physician or nurse caring for the patient in the hospital). To minimize the risk of contamination across study arms, we will only approach one patient per hospital room in shared rooms
结局指标
主要结局
Change in mean daily step count during hospitalization
时间窗: Average 5 days
The primary outcome variable is the change in mean daily step count during hospitalization (from enrollment to discharge).
次要结局
- Proportion of patients who attain pre-specified step thresholds during hospitalization and after discharge(Average 35 days)
- Discharge to post-acute facilities(30 days)
- Change in difficulty with walking(Average 35 days)
- 30-day acute care utilization(30 days)
- Change in life space assessment(Average 35 days)
- Hospital length of stay(Average 5 days)
- Change in activities of daily living(Average 35 days)
研究者
Ryan Greysen
Ryan Greysen, MD, MHS, MA
University of Pennsylvania