RecruitingNot ApplicableNCT05725928

Assisted Ambulation to Improve Health Outcomes for Older Medical Inpatients

Randomized Trial of Assisted Ambulation to Improve Health Outcomes for Older Medical Inpatients

Sponsor

The Cleveland Clinic

Enrollment

3,000 participants

Start Date

May 15, 2023

Study Type

INTERVENTIONAL

Conditions

Mobility Limitation Frailty Hospital Acquired Condition Weakness, Muscle

Summary

The investigator proposes to conduct a randomized trial of supervised ambulation delivered by mobility technician (MT) up to three times daily, including weekends, to hospitalized medical patients. The aims of the study are to compare the short and intermediate-term outcomes of patients randomized to the intervention versus those patients randomized to receive usual care, to identify patients who are most likely to benefit from the intervention and to assess whether the intervention increases or decreases overall costs of an episode of care, including the cost of the MTs, the index hospitalization and the first 30 days post enrollment.

Eligibility

Min Age: 65 Years

Inclusion Criteria5

≥65 years of age
Admitted to a medical service
Complete history and physical examination on file
Clicks score of 16-23
Insurance with Traditional Medicare or Medicare Advantage

Exclusion Criteria11

Significant language barrier that requires a translator (other than Spanish at Baystate site only)
Discharge planned for that day or the following day
Observation status
Surgical procedure planned
Patients diagnosed with unstable angina or other medical conditions precluding participation in exercise/ambulation
Permanent residence in a skilled nursing facility
Comfort care measures only
\>48 hours since admission
Active infection with COVID-19
Other active infection requiring contact or droplet precautions
Order for bedrest

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Interventions

BEHAVIORALMobility technician

Designated mobility technicians (MT) will ambulate hospitalized medical patients up to 3 times daily, 7 days per week, until discharge or a maximum of 10 days. Each day, the MT will visit the patient 4 times or until the patient successfully ambulates 3 times that day. In cases where a PT has provided a recommendation in the patient's chart, the MT will follow the recommendation, if feasible. Otherwise, the MT will execute the standard mobility protocol. The mobility protocol will allow the MT to assist a patient with an appropriate out-of-bed activity based on their 6-clicks score from the immediately preceding session.