Goal-directed Mobilization of Medical Inpatients

Insel Gruppe AG, University Hospital Bern160 enrolled

Overview

Immobilization in general internal medicine inpatients is a major contributor to morbidity and mortality. Goal-directed mobilization (GDM) may improve mobility. The aim of this study is to assess, if GDM increases physical activity (DEMMI score) during hospitalization and improves quality of care until 3 months after hospitalization.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

PREVENTION

Masking

SINGLE

Enrollment

160

Conditions

Immobility Syndrome Fall Delirium Sarcopenia Mobility Limitation Hospital Acquired Condition

Interventions

Goal-directed mobilizationBEHAVIORAL

* A short educational intervention with handout of a leaflet on GDM. * Definition of personal mobility goal level. * Communication of the mobility goal level to involved stakeholders. * Regular reassessment of the mobility goal level and "booster sessions" by physiotherapists.

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * All consenting patients aged ≥ 18 years admitted to the Department of General Internal Medicine, Inselspital, Bern University Hospital, Bern, Switzerland, who have an indication for physiotherapy (prescription by the resident in charge or the care coordinator). * Participants must be randomized at latest on the second day after hospital admission. * Written informed consent. Exclusion Criteria: * Inability to follow study procedures, i.e., due to language problems (unable to read, speak or understand German), psychological disorders, severe dementia (defined as to levels 5 - 7 in the Global Deterioration Scale), blindness, Patients unable to provide informed consent themselves * Expected hospital stay for \< 5 days * Medically indicated bedrest for more than 24 h, e.g. after surgery * Injuries or neurologic deficits of one or both lower extremities directly impairing walking capacity (e.g. fractures, hemiplegia, previous use of a wheelchair or bedriddenness) * Terminal illness * Pregnancy or breast feeding * Previous enrolment in this study * Enrolment of the investigator, his/her family members, employees and other dependent persons

Locations (1)

Inselspital, Bern University Hospital

Bern, Canton of Bern, Switzerland

Outcomes

Primary Outcomes

Change from baseline of the DEMMI score

Change of the de Morton Mobility Index (DEMMI) score (range 0 to 100 with 0 indicating poor physical activity and 100 indicating a high level of independent physical activity) from baseline (at study inclusion), assessed by independent, blinded physiotherapist

Time frame: Day 5±2

Secondary Outcomes

Change from baseline of the DEMMI score

Time frame: Hospital discharge (max. day 14±2)

Mobilization time

Mobilization time measured by accelerometer (i.e., time "moving" as total of time "inactive" and "static", excluding time "not worn")

Time frame: Day 5±2

Mobilization time

Mobilization time measured by accelerometer (i.e., time "moving" as total of time "inactive" and "static", excluding time "not worn")

Time frame: During hospitalization (max. 14±2 days)

Number of delirium episodes

As recorded in the discharge letter and nurse's protocol

Time frame: During hospitalization (max. 14±2 days)

Number of in-hospital falls

As recorded in the nurse's protocol ("fall protocol")

Time frame: During hospitalization (max. 14±2 days)

Length-of-hospital-stay

Data from ClinicalTrials.gov

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