Promoting activity for frail aged in post-acute hospital settings: a randomised controlled trial of accelerometry

INTERVENTION: Participants will wear an accelerometer from the time of waking in the morning until going to bed in the evening ie during waking hours. The accelerometer will be removed for showering. At commencement, the treating physiotherapist will discuss with the patient their mobility goals, including provisional targets for daily walking time. These goals will be re‐examined and modified, informed by the accelerometer data, to motivate the patient to improve activity levels and reach set targets. The targets will be reviewed weekly until discharge or 4 weeks, whichever is sooner. Feedback of the previous day’s walking time will be given to the patient and treating therapist and will be recorded in the patient’s records. Walking times over a week will be summarised in chart form and made available at the weekly case conference. All staff will be trained in the use of accelerometry data and be asked to encourage patients to meet their activity goals. CONDITION: Mobility decline Musculoskeletal De‐conditioning PRIMARY OUTCOME: Daily walking times as assessed by accelerometry SECONDARY OUTCOME: Exercise self‐efficacy as measured by the Short Self‐Efficacy and Outcome Expectation for Exercise Scales Functional status as assessed using the interRAI Post‐Acute Care instrument Health‐related quality of life as measured by EQ‐5D Length of stay recorded on hospital discharge records Lower extremity function as measured by the Short Physical Performance Battery INCLUSION CRITERIA: Patients admitted to post‐acute care rehabilitation who are (1) aged greater than or equal to 60 years; (2) able to ambulate independently or with supervision, or who have a rehabilitation goal to become ambulant within the context of the current admission; and (3) expected to have a length of stay of at least 2 weeks will be eligible to participate.