WalkMORE: A Volunteer-driven Walking Intervention

NCT03888027 | Suspended DMC

• 1 other identifier: ReDA 6072
• Study Type: interventional
• Target: 800
• 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 volunteers, 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 volunteer will have reduced length-of-stay in hospital and decreased likelihood of readmission. Finally, as shown in other similar programs, the investigators anticipate an overall improvement in the patient experience. The investigator's novel initiative focuses on a single, volunteer-based intentional ambulation program that can deliver the benefits of early mobility in a cost-effective way. The program design engages trained volunteers to increase patient ambulation in a way that both increases patient mobility and reduces healthcare professionals' workload.

Conditions

Frailty; Deconditioning; Early Ambulation

Outcome Measures

Primary Outcomes (3)

• Re-hospitalization

  Number of patients re-admitted to hospital

  30 days after randomization

• Presentation to emergency department

  Number of patients seen in the hospital emergency department

  30 days after randomization

• Prolonged index hospital admission

  Number of patients with extended length of hospital admission

  30 days after randomization

Secondary Outcomes (8)

• Length of stay for index hospital admission

  30 days after randomization

• Post-discharge Falls

  30 days after randomization

• Timed-Up-And-Go

  30 days after randomization

• Barthel Index

  30 days after randomization

• Frailty

  30 days after randomization

Study Arms (2)

Control

NO INTERVENTION

Patients receive no intervention

WalkMORE group

ACTIVE COMPARATOR

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 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.

Behavioral: WalkMORE group

Interventions

WalkMORE group BEHAVIORAL

Hospitalized Internal Medicine patients will walk with trained volunteers 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 daily by the health care team
• Cognitively safe for participation
• Anticipated to remain hospitalized ≥48 hours
• Inpatient, admitted to Internal Medicine at University Hospital
• 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.
• Communication barrier (due to hearing/vision impairment, or language barrier)
• Patients receiving treatment from an LHSC inpatient Physiotherapist.

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

MeSH Terms

Conditions

Frailty

Condition Hierarchy (Ancestors)

Pathologic Processes; Pathological Conditions, Signs and Symptoms

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Purpose: SUPPORTIVE CARE
• 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: March 13, 2019
• First Posted: March 25, 2019
• Study Start: May 6, 2019
• Primary Completion: March 13, 2020
• Study Completion: March 13, 2026
• Last Updated: October 15, 2024

Record last verified: 2024-03

Locations

CA (1)