WalkMORE: Volunteer Walking Coach Program for Hospitalized Internal Medicine Patients

NCT03361891 | Completed

• 1 other identifier: ReDA 4304
• Study Type: interventional
• Target: 150
• Locations: 1 country
• Sites: 1

Brief Summary

Patients admitted to hospital typically experience periods of decreased activity or bed-rest. This reduced activity level leads to deconditioning - a loss of muscle mass, muscle strength (by 2-5% per day), and muscle shortening. Even among patients who were ambulatory at the time of admission, deconditioning has been linked with deleterious effects, such as increased rates of falls, functional decline, and frailty. Furthermore, it has been suggested that the physiological stresses associated with hospitalization - including deconditioning, as well as sleep deprivation and poor nutrition - makes discharged patients vulnerable to recurrent or new illnesses and to frailty. This physiological stress-induced vulnerability has been coined post-hospital syndrome and is thought to have a role in most hospital readmissions. The investigators hypothesize that by engaging ambulatory patients to walk with trained volunteer coaches, patients will increase their amount of walking, have less deconditioning and functional decline, and consequently, fewer falls. Furthermore, the investigators anticipate that patients who walk with a trained coach will have reduced length-of-stay in hospital and decreased likelihood of readmission. Finally, as shown in other programs trialing health coaches, the investigators anticipate an overall improvement in the patient experience. Our aim is to demonstrate the feasibility of an intentional walking protocol called WalkMORE, which pairs trained volunteer coaches with ambulatory patients admitted to the Internal Medicine unit (4th floor University Hospital), aimed at decreasing deconditioning through increased walking.

Conditions

Early Ambulation

Outcome Measures

Primary Outcomes (1)

• Patient Recruitment

  Ability to recruit sufficient number of patients

  3 months

Secondary Outcomes (1)

• Patient Safety

  6 months

Study Arms (2)

Control

NO INTERVENTION

Patients receive no intervention

WalkMORE group

EXPERIMENTAL

WalkMORE Ambulation program. Patients will ambulate with a trained WalkMORE Volunteer Coach two times per day; once in the morning (0900-1200hrs) and once in the afternoon (1300-1700hrs), Monday- Friday, until hospital discharge.

Behavioral: WalkMORE Group

Interventions

WalkMORE Group BEHAVIORAL

Hospitalized Internal Medicine patients will walk with trained volunteer coaches twice daily until hospital discharge

WalkMORE group

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Capable and appropriate for independent ambulation (with or without gait aids) as determined by the health care team at time of admission
• Cognitively safe for participation
• Anticipated to remain hospitalized ≥48 hours
• Age \>18 years

You may not qualify if:

• Preexisting condition precludes patient from independent ambulation at time of admission.
• Active medical condition precludes patient from safely participating.
• Preexisting condition or active medical condition renders patient unfit to participate as judged by the admitting team.
• Patients who refuse to participate or are unable to provide informed consent.
• Patients that are non-English speaking.

Sponsors & Collaborators

• London Health Sciences Centre Research Institute OR Lawson Research Institute of St. Joseph's: lead

Study Sites (1)

LHSC-University Hospital

London, Ontario, N6A 5A5, Canada

Location

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Purpose: PREVENTION
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Model Details: Patients will be randomized via REDCap (Research Electronic Data Capture), a secure, centralized web-based randomization module to: 1. Standard of care; or 2. WalkMORE Ambulation program + Standard of care. Patients will ambulate with a trained WalkMORE Volunteer Coach two times per day; once in the morning (0900-1200hrs) and once in the afternoon (1300-1700hrs), Monday- Friday, until hospital discharge. Patients randomized to the WalkMORE intervention will be assessed daily by the Research Coordinator to ensure patients remain fit for independent ambulation. The duration of each walking session will be determined daily by the RC and the medical team.

Study Record Dates

• First Submitted: November 27, 2017
• First Posted: December 5, 2017
• Study Start: June 6, 2018
• Primary Completion: December 10, 2018
• Study Completion: January 9, 2019
• Last Updated: March 15, 2019

Record last verified: 2019-03

Data Sharing

• IPD Sharing: Will not share

Locations

CA (1)