Mobility Promotion for Frailty

Overseen By Myles W O'Brien, PhD

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Université de Sherbrooke

Disqualifiers: Other clinical trials, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

Duration: 2 weeks

60 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to determine if more frequent visits from a kinesiologist (a movement expert) can help hospital patients reduce frailty and improve recovery. Frailty can impact the ability to perform daily tasks, especially after hospitalization. The study will compare patients receiving one visit a day with those receiving multiple visits to assess whether increased visits improve mobility and shorten hospital stays. The trial seeks participants aged 50 or older who expect to stay in the hospital for at least three days. As an unphased trial, it offers a unique opportunity to contribute to research that could enhance recovery strategies for future patients.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It might be best to discuss this with the trial coordinators or your doctor.

What prior data suggests that this mobility promotion program is safe for patients with frailty?

In a previous study, patients demonstrated significant improvements in mobility from hospital admission to discharge after receiving regular visits from movement specialists who helped them stay active. Other research supports this, showing that mobility training improves movement in frail older adults. These findings suggest that programs like the one being tested are safe for participants. No reports of harmful effects from these activities exist; instead, they appear to enhance physical abilities. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about this mobility promotion trial for frailty because it introduces a hands-on, personalized approach to help patients stay active. Unlike standard treatments that might rely on medications or passive therapies, this method involves kinesiologists working directly with patients every day, encouraging them to move to the best of their abilities. This proactive and supportive engagement could lead to better outcomes by enhancing mobility and independence, which is crucial for frail individuals.

What evidence suggests that this mobility promotion program is effective for reducing frailty?

Research has shown that exercise can greatly benefit older adults who are frail by strengthening muscles and reducing the risk of falls. Studies have found that combining exercise with nursing care improves physical abilities, independence, and balance. For older adults, staying active is crucial to prevent mobility loss. Exercise programs that include various activities have improved frailty and enhanced both physical and mental abilities. In this trial, a team of kinesiologists will visit patients daily to promote movement and help them mobilize to the best of their abilities. A previous study found that patients who regularly met with exercise specialists became less frail and moved better by the time they left the hospital. These findings support the idea that encouraging movement can effectively reduce frailty in hospitalized patients. ^{6 7 8 9 10}

Are You a Good Fit for This Trial?

This trial is for hospitalized patients living with frailty, who are at risk of functional decline and longer hospital stays. It aims to help them recover better by promoting physical activity during their stay. The study will include those willing to be monitored and assessed for frailty levels.

Inclusion Criteria

I am 50 years old or older.

I will be in the hospital for at least 4 days.

Patients not in a shared room with another study participant

Exclusion Criteria

Patients enrolled in other clinical trials or interventions that might confound the results of the study

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

1 week

Treatment

Kinesiologists visit patients daily to promote movement and help them mobilize to the best of their capabilities

2 weeks

Daily visits (in-person)

Follow-up

Participants are monitored for safety and effectiveness after treatment

4 weeks

What Are the Treatments Tested in This Trial?

Interventions

• Mobility promotion

Trial Overview The trial tests if a patient mobilization program with daily visits from Kinesiologists can improve health outcomes in frail patients. It compares usual care (one visit/day) against multiple check-ins, measuring step counts, upright time, frailty level changes, length of stay, and readmission rates.

How Is the Trial Designed?

Group I: Males Experimental Treatment 1 Intervention

A team of Kinesiologists visit the patients daily from admission to discharge to promote movement and help them mobilize to the best of their capabilities (e.g., walking, standing, or sitting on the edge of the bed).

Group II: Females Experimental Treatment 1 Intervention

A team of Kinesiologists visit the patients daily from admission to discharge to promote movement and help them mobilize to the best of their capabilities (e.g., walking, standing, or sitting on the edge of the bed).

Who Is Running the Clinical Trial?

Université de Sherbrooke

Lead Sponsor

Trials

317

Recruited

79,300+

Vitalite Health Network

Collaborator

Trials

3

Recruited

130+

Published Research Related to This Trial

In a study of 119 community-dwelling older adults, balance deficits and physical activity measures were identified as independent predictors of future falls, particularly in pre-frail and frail individuals, but not in non-frail participants.

Gait performance declined with increasing frailty, yet it did not serve as a reliable predictor of falls when considering frailty status, highlighting the importance of balance and activity levels over gait in assessing fall risk.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Motor Performance and Physical Activity as Predictors of Prospective Falls in Community-Dwelling Older Adults by Frailty Level: Application of Wearable Technology. Mohler, MJ., Wendel, CS., Taylor-Piliae, RE., et al.[2018]

A 12-month multidisciplinary intervention targeting frailty in 241 older adults significantly reduced frailty by 1.0 criterion and improved mobility by 3.2 points for those who complied with the treatment, indicating a strong efficacy for compliant participants.

The overall effect of the intervention was much greater for those who adhered to the treatment compared to the average effect across all participants, highlighting the importance of compliance in achieving better health outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A multifactorial intervention for frail older people is more than twice as effective among those who are compliant: complier average causal effect analysis of a randomised trial. Fairhall, N., Sherrington, C., Cameron, ID., et al.[2019]

Increasing physical activity through mobility training can significantly reduce frailty in older adults, leading to better health outcomes.

Mobility is crucial for maintaining independence and well-being in older adults, highlighting the importance of targeted interventions in community settings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effectiveness of mobility training for frail older adults living in the community. Harrison, J., Phoong, KY., Mansoor, M., et al.[2023]

In a study of 754 older adults over 5 years, transitions between mobility disability states were common, with higher rates of moving from no disability to intermittent disability and from intermittent to continuous disability.

Older age, female sex, and physical frailty increased the likelihood of worsening mobility, highlighting the need for programs that not only prevent disability but also help restore and maintain mobility in older individuals.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The dynamic nature of mobility disability in older persons. Gill, TM., Allore, HG., Hardy, SE., et al.[2022]

Researchers at the University of Manchester are developing a behavior change intervention aimed at pre-frail older adults to encourage participation in group-based physical activity classes, which have been shown to effectively slow the progression of frailty.

There is strong support from stakeholders for proactively addressing pre-frailty, as a significant number of older adults are affected, suggesting that such interventions could enhance healthy aging and improve overall health outcomes in this population.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Acceptability of physical activity signposting for pre-frail older adults: a qualitative study to inform intervention development. Money, A., Harris, D., Hawley-Hague, H., et al.[2023]

In a study of 1,814 older adults in Ireland, 7.7% were classified as frail and 44.0% as prefrail, highlighting the prevalence of frailty in this population.

The Timed Up-and-Go (TUG) test effectively identifies frail individuals (AUC = 0.87) but is less effective at distinguishing between nonfrail and prefrail individuals (AUC = 0.73), indicating that while TUG is a useful tool, it cannot replace the comprehensive assessment of frailty components.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Using timed up-and-go to identify frail members of the older population. Savva, GM., Donoghue, OA., Horgan, F., et al.[2022]

A 12-month multifactorial intervention significantly improved mobility-related disability in 241 frail older adults, as evidenced by better scores on the Goal Attainment Scale and Life Space Assessment compared to the control group.

Participants in the intervention group also demonstrated a slight increase in walking speed and higher scores on activity measures, indicating enhanced mobility and participation in daily life activities.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effect of a multifactorial interdisciplinary intervention on mobility-related disability in frail older people: randomised controlled trial. Fairhall, N., Sherrington, C., Kurrle, SE., et al.[2022]

The MoveStrong program, an 8-week exercise and nutrition intervention delivered via telephone and virtual sessions, was feasible and well-accepted by older adults, with a high retention rate of 93% and adherence to sessions exceeding 80%.

Participants showed significant improvements in physical function, as evidenced by increased chair stand test scores and enhanced dietary protein intake, indicating the program's effectiveness in addressing frailty in older adults.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

MoveStrong at home: a feasibility study of a model for remote delivery of functional strength and balance training combined with nutrition education for older pre-frail and frail adults. Wang, E., Keller, H., Mourtzakis, M., et al.[2022]

In a study of 8533 older adults with an average age of 72, frailty and not driving were both linked to a higher risk of disability, with 5.3% of frail individuals becoming disabled compared to only 1.3% of non-frail individuals.

Frail individuals who do not drive had a significantly higher risk of disability (HR: 2.28) compared to those who are not frail and drive, indicating that both frailty and driving status are important factors in assessing disability risk in older adults.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Frailty and driving status associated with disability: a 24-month follow-up longitudinal study. Doi, T., Tsutsumimoto, K., Ishii, H., et al.[2021]

Citations

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Physical Exercise Intervention Characteristics and ... Exercise can serve as an effective intervention for pre-frail and frail older adults, improving muscle strength and reducing the risk of falls.

2. sciencedirect.com sciencedirect.com/science/article/pii/S0011393X24000390

Assessing the Impact of Frailty Interventions on Older ... This study demonstrates that combining active exercise with nursing interventions significantly improves physical performance, independence, balance, muscle ...

3. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC7508031/

Preserving Mobility in Older Adults with Physical Frailty and ... One of the strategies that have shown some benefits in combatting mobility loss and its consequences for older adults is physical activity. Here ...

4. academic.oup.com academic.oup.com/ptj/article/102/12/pzac138/6749066

A Cluster-Randomized, Stepped Wedge Trial | Physical Therapy Coach2Move has been shown to increase physical activity, improve functional mobility, and reduce frailty more effectively compared with UCP ...

5. mdpi.com mdpi.com/2077-0383/13/21/6570

The Effect of Exercise Program Interventions on Frailty ... The results demonstrated that multicomponent exercise programs significantly improved frailty status, enhanced physical and cognitive function, and improved ...

6. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC9245897/

Mobility training for increasing mobility and functioning in ... Mobility training improves mobility in frail older people, with a 1.00 point increase in mobility score. It may also improve functioning, with an 8.58 point ...

7. sciencedirect.com sciencedirect.com/science/article/pii/S2950307824001012

Dance programme for older adults with pre-frailty This study aimed to evaluate the feasibility of a 12-week Dance-Up program and test its effects on the physical and psychosocial well-being of older adults ...

8. bmj.com bmj.com/content/377/bmj-2021-068788

randomised controlled trial (SPRINTT project) The multicomponent intervention was associated with a decrease in the risk of incident mobility disability in those with SPPB scores of 3 to 7, ...

9. thelancet.com thelancet.com/journals/lanhl/article/PIIS2666-7568(24)00196-X/fulltext

Clinical and cost-effectiveness of a home-based health ... Health promotion for people with mild frailty has the potential to improve health outcomes, but such services are scarce in practice.

10. link.springer.com link.springer.com/article/10.1007/s41999-023-00869-9

Mobility outcomes and associated factors of acute geriatric ... Patients showed significant increases in locomotor capacity, physical activity, and life-space mobility from hospital admission to discharge.