Frail, Inpatients
Conditions
Keywords
inpatients, physical activity, reminder device, frailty, functional independancy
Brief summary
Around 30% of patients aged 65 and over experience functional decline due to hospitalization. Physical inactivity, often without medical justification, is common during hospital stays.This immobility leads to loss of autonomy, muscle strength, and increases post-discharge risks. Slow walking for 25-40 minutes daily significantly improves functional capacity. However, it could be difficult to reach this time of walking due to a lack of physiotherapist in hospital. A vibrating watch may encourage patients to walk or perform strengthening exercises. This simple intervention aims to improve function without requiring additional staff or resources
Detailed description
30% of patients aged 65 or older will experience a decline in functional capacity as a result of hospitalization. Illness and hospitalization increase sedentary behavior in patients. It is common for patients to spend long periods of time resting in bed, regardless of their primary reason for admission. During hospitalization, nearly 60% of episodes of bed rest have no documented medical indications. Low physical activity during hospitalization can lead to impaired independence, loss of muscle strength, and decreased functional capacity. These losses in frail individuals are associated with increased disability and lead to a critical 30-day period after hospital discharge that exacerbates deconditioning. This period of increasing functional vulnerability can lead to readmission to hospital, disability, institutionalization, morbidity, and early mortality. The results of a meta-analysis show that walking slowly for about 25-40 minutes per day is sufficient to improve patients' functional capacity during hospitalization. The organization of care to promote patient mobility must be reviewed to make patients more involved in their care and more independent. It has been demonstrated for some time that the use of a reminder system (e.g., alarm) is a factor that promotes increased patient adherence to their treatments. The advantage of a vibrating reminder is that it is simple to use, very inexpensive, easy to implement in all hospital wards, and does not require additional human resources. The main hypothesis of this study is that the use of a vibrating watch set to 6 reminders per day to prompt patients to perform muscle strengthening exercises or walk a distance determined by the rehabilitation professional will increase patients' functional capacity.
Interventions
DEVICEVibrating reminder
The exercises will be prescribed according to the patient's physical abilities and environmental constraints. A vibrating reminder will be given to the patient, set to go off six times a day.
DEVICEControl group
The exercises will be prescribed according to the patient's physical abilities and environmental constraints. A vibrating reminder will be given to the patient, set to go off once time a day.
Sponsors
Groupe Hospitalier du Havre
Centre Hospitalier de Valence
Centre Hospitalier of Chartres
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
TRIPLE (Subject, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
50 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Patients aged 50 or over with a score of 4 or above on the Clinical Frailty Scale (vulnerable but not dependent patients, symptoms limiting activities, patients who are slower/more fatigued). * Must be able to get up from a chair without assistance. * Patients must be able to communicate with staff, understand instructions, give consent, and cooperate with staff.
Exclusion criteria
* Patients with an estimated hospital stay of less than 5 days. * Contraindications to physical activity determined by the medical team (e.g., cardiovascular instability, orthopedic contraindications, etc.). * Terminal illness. * Patients scheduled for surgery. * Pregnant women. * People who do not understand French. * People protected under the law.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| SPPB | Within 24 hours of admission and within 48 hours prior to discharge from hospital. | The SPPB (Short Physical Performance Battery) is the sum of scores on three criteria: the balance test, the walking speed test, and the chair rise test. This test assesses an individual's physical performance. The score ranges from 0 (lowest) to 12 (highest). The magnitude of change considered clinically relevant for the SPPB is 1 point. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Volume and intensity of physical activity | Within 24 hours of admission and within 48 hours prior to discharge from hospital. | The number of steps per day and the number of movements per minute will be measured.An accelerometer will be placed on the wrist of the non-dominant limb. Data will be measured 24 hours a day. |
| functional independancy | Within 24 hours of admission and within 48 hours prior to discharge from hospital. | Will be measured using the Barthel Index, based on the patient's level of independancy during the week prior to hospitalization and upon discharge from the hospital. The Barthel Index assesses a person's ability to perform ten essential activities of daily living. |
| Patient compliance to the prescribed exercises | Within 24 hours of baseline and within 48 hours prior to discharge from hospital | Compliance will be measured using a compliance record sheet. This will enable us to note whether the exercises have been performed, and if so, the number of times per day, the schedule, the type, the reason for interruption, and whether or not there has been any pain, rated from 0 to 10. |
| falls | Within 24 hours of baseline and within 48 hours prior to discharge from hospital ; and at 3 months after discharge. | number of falls during hospitalization |
| Volume and type of rehabilitation in-hospital | Within 24 hours of baseline and within 48 hours prior to discharge from hospital | performed by physiotherapist |
| The volume and location of rehabilitation | at 3 months after discharge | performed by rehabilitation professionals after discharge |
| Health-related Quality of life | 24 hours after admission, 48 hours before discharge, and 3 months after hospitalization | mesured by EuroQol(5-5). It assesses quality of life according to five main dimensions: mobility, independence, daily activities, pain and discomfort, anxiety, and depression. Each dimension is assessed on a five-point severity scale. The score ranges from 0 to 100 (best possible health) |
Countries
Belgium, France
Contacts
CONTACTGuillaume Prieur, PT, PhD
CONTACTYann Combret, PT, PhD
PRINCIPAL_INVESTIGATORLéa Bansard, PT, MSc
Groupe Hospitalier du Havre
PRINCIPAL_INVESTIGATORGuillaume Prieur, PT, PhD
Groupe Hospitalier du Havre
STUDY_DIRECTORYann Combret, PT, PhD
Groupe Hospitalier du Havre
STUDY_CHAIRClément Medrinal, Prof.
Groupe Hospitalier du Havre
Outcome results
None listed