None listed
Conditions
Brief summary
BACKGROUND A goal in rehabilitation for older people is promotion of mobility to reverse functional decline and deconditioning. Recent developments in accelerometry for quantifying ambulatory activity can assist clinical practice in rehabilitation settings. AIM The study tests the hypothesis that use of accelerometry to provide accurate activity data to patients and clinicians, in the context of explicit goal setting, substantially increases patient walking activity. The study will also explore the effects of increased activity on patient outcomes and undertake a cost utility analysis. RESEARCH PLAN A randomised controlled trial will be conducted in Geriatric Rehabilitation Units at 3 sites (QLD, NSW, SA). Eligible patients are aged greater than or equal to 60 and able to ambulate. Based on pilot data, a sample size of 270 patients (135 per group) is required to demonstrate a mean significant differencein daily walking time of 33% between intervention and control groups.Accelerometers will be fitted to eligible subjects to monitor daily activity. Intervention subjects will be offered a formal activity-related rehabilitation goal, and receive daily feedback, sourced from the accelerometer, of their activity levels. Neither staff nor subjects in the control arm of the trial will receive data on walking times. The primary outcome measure will be walking times measured by accelerometry. Secondary outcome measures will include lower extremity function, quality of life, length of stay, post discharge hospital readmissions and level of care at one month follow-up. The time frame for the study is two years six months. SIGNIFICANCE If patient activity can be increased through the use of accelerometer data, it will revolutionise the management of activity in hospital. There will be enormous impetus to further develop accelerometer technology for clinical application so that activity prescription will be a routine component of a rehabilitation care plan.
Interventions
Participants will wear an accelerometer from the time of waking in the morning until going to bed in the evening ie during waking hours. The accelerometer will be removed for showering. At commencement, the treating physiotherapist will discuss with the patient their mobility goals, including provisional targets for daily walking time. These goals will be re-examined and modified, informed by the accelerometer data, to motivate the patient to improve activity levels and reach set targets. The t
Participants will wear an accelerometer from the time of waking in the morning until going to bed in the evening ie during waking hours. The accelerometer will be removed for showering. At commencement, the treating physiotherapist will discuss with the patient their mobility goals, including provisional targets for daily walking time. These goals will be re-examined and modified, informed by the accelerometer data, to motivate the patient to improve activity levels and reach set targets. The targets will be reviewed weekly until discharge or 4 weeks, whichever is sooner. Feedback of the previous day’s walking time will be given to the patient and treating therapist and will be recorded in the patient’s records. Walking times over a week will be summarised in chart form and made available at the weekly case conference. All staff will be trained in the use of accelerometry data and be asked to encourage patients to meet their activity goals.
Sponsors
The University of Queensland
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Blinded (masking used) (Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
All
Age
60 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Patients admitted to post-acute care rehabilitation who are (1) aged greater than or equal to 60 years; (2) able to ambulate independently or with supervision, or who have a rehabilitation goal to become ambulant within the context of the current admission; and (3) expected to have a length of stay of at least 2 weeks will be eligible to participate.
Exclusion criteria
Exclusion criteria will be those (1) with lower limb amputation; (2) with delirium/agitated dementia; or (3) not expected to walk within 4 weeks of admission.
Outcome results
None listed