None listed
Conditions
Brief summary
The primary purpose of this pilot project is to demonstrate the feasibility of a randomised controlled trial (RCT) investigating whether older people undergoing rehabilitation who receive feedback on activity levels are more active than patients who do not receive feedback. One of the main reasons older people are admitted for rehabilitation is to improve their mobility. There is increasing evidence indicating that mobility is improved by increasing physical activity. However, studies have shown that physical activity levels are very low in people undergoing rehabilitation. One difficulty for therapists is that to date there has been no way of easily measuring or monitoring activity levels in patients. It is therefore difficult to know how active a person really is, and whether their activity levels are improving during their rehabilitation stay. There are now devices available that can provide accurate feedback about activity levels, even in people who have very low levels of mobility and activity. One device is the SenseWear armband, which is the size of a watch and can measure even small changes in activity. The SenseWear armband has an optional display unit, which provides the person and their therapists with real time feedback about their level of activity. Studies in community dwelling groups have shown that feedback about activity levels can be used to improve activity. However, older people undergoing rehabilitation are typically more frail and dependent on staff to assist them be active. Hence, it is not known whether providing feedback to older people undergoing rehabilitation will lead to increased activity levels. Forty older people admitted for inpatient rehabilitation will be randomly allocated to either receive feedback and develop activity goals based on their activity level (intervention group) or monitoring of activity without feedback (control group). All participants will wear a Sensewear device for up to 3 weeks while undertaking inpatient rehabilitation. The results of the pilot will be utilised to inform the design and need for a future RCT. If we find that feedback provided by Sensewear device can promote activity, we shall further investigate if ongoing use can maximise activity level and mobility outcomes and reduce length of stay during inpatient rehabilitation.
Interventions
Regular monitoring and goal setting using feedback on physical activity levels provided via an activity monitor device. Participants in the intervention group will wear a SenseWear armband and the SenseWear display monitor during waking hours (approximately 16 hours per day). The display unit will provide information about the participant's level of activity throughout the day. This information will be used by the physiotherapist and the participant to set individual daily and weekly activity
Regular monitoring and goal setting using feedback on physical activity levels provided via an activity monitor device. Participants in the intervention group will wear a SenseWear armband and the SenseWear display monitor during waking hours (approximately 16 hours per day). The display unit will provide information about the participant's level of activity throughout the day. This information will be used by the physiotherapist and the participant to set individual daily and weekly activity targets. This will be done in the participants usual physiotherapy sessions. Participants in these wards typically recieve physiotherapy once or twice a day on weekdays. Sessions can be delivered on an individual basis or group basis, as is usual practice. Where appropriate, family members are invited to attend physiotherapy sessions if they are able. The length of the physiotherapy sessions will be determined by the treating physiotherapist, as per usual practice, however physiotherapists will be required to record the amount of time spent in physiotherapy sessions. Physiotherapists will educate participants, other staff and their families about the information provided on the display unit, so they can monitor progress towards goals. Techniques such as graphing progress towards activity goals will be used to increase the patient’s motivation and adherence towards achieving these goals. The intervention will cease either when the participant is discharged from rehabilitation or after a period of 3 weeks (which ever occurs first).
Sponsors
Dr Catherine Said
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Blinded (masking used) (Investigator)
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
To be eligible for inclusion, participants must: * Be admitted to Mellor ward (Royal Talbot), ward 11 or 12 (Heidelberg Repatriation Hospital) * Be aged over 18, * have as a goal of admission ‘improve upright mobility or improve walking, as determined by either the admission referral or the treating therapist. * Have an anticipated length of stay greater than one week. People with very short length of stays may not have sufficient time to modify activity based on feedback.
Exclusion criteria
Participants will be excluded if * the primary reason for admission is to await placement in residential care or primarily for carer training, * they have been identified as not requiring physiotherapy on admission, * there are medical restrictions on mobilization or activity (e.g. non weight bearing). * The mobility goals are non-weight bearing goals (eg goal is to improve bed mobility/ slide board transfers) * They are involved in another interventional study * They have had a lower limb amputation. Upright mobility for this group is often dependent on factors such as wound healing and prosthesis fit. * Are cognitively impaired or unable to give consent. Part of the intervention involves working with the participant to set and achieve goals. This would be difficult for participants who are cognitively impaired. * They have an anticipated LOS of less than a week.
Outcome results
None listed