Early AmbulationNCT03361891
WalkMORE: Volunteer Walking Coach Program for Hospitalized Internal Medicine Patients
A study testing WalkMORE Group in people with Early Ambulation, run by London Health Sciences Centre Research Institute OR Lawson Research Institute of St. Joseph's at 1 site in Canada.
Trial 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. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Early Ambulation
- What is being tested?
- WalkMORE Group
- Type of treatment
- Lifestyle or therapy programme
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 150 participants
- Where
- 1 siteCanada
- Study dates
- 6 Jun 2018to 9 Jan 2019
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- 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
Who cannot join
- 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.
Trial locations and contacts
1 site in 1 country.
About this study
Official title: WalkMORE: Volunteer Walking Coach Program for Hospitalized Internal Medicine Patients, a Pilot Randomized Controlled Trial
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.
Read the detailed description
WalkMORE is a single-center randomized controlled trial. The investigators will enroll up to 300 ambulatory patients admitted to the Internal Medicine unit (located on the 4th floor of University Hospital) who are >18 years of age and are anticipated to require a >48 hour hospital admission. A maximum of 6 patients will be assigned to each treatment arm at any given time. The investigators will recruit patients into the WalkMORE program over a 3-month period. The research coordinator (RC) will screen patients admitted to the Internal Medicine unit in the preceding 24-hour period to identify patients who fulfill the eligibility criteria. Patients will be randomized via REDCap (Research Electronic Data Capture), a secure, centralized web-based randomization module to:
- Standard of care; or
- 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 RC 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.
After obtaining written informed consent from eligible patients the RC will randomize patients, collect demographics, hospital admission details and perform a quality of life survey (EQ-5D) with all patients. All patients will be assigned a scientific pedometer on the day of randomization. The modus Health StepWatch™ is an activity monitor worn on the ankle via a velcro strap. It is a small, lightweight device that will count and record patients' steps throughout their hospital stay. The device is smaller than a deck of cards (7.5 x 5.0 x 2.0 cm) and weighs 38 grams and will be installed by the RC. The total number of steps recorded on the pedometer will be collected for each patient every day until hospital discharge. For patients randomized to the WalkMORE intervention arm, the total number of minutes walked with a volunteer coach will also be recorded for each session until discharge. Functional ability will be measured on the third day post-randomization and every three days thereafter until hospital discharge, using the Timed Up and Go test (patients will be asked to stand up from a chair, walk three metres, turn around, walk back to the chair, and sit). After hospital discharge the RC will follow up with patients for 2 brief telephone interviews. On day 3 after discharge, Patient Satisfaction surveys will be conducted by the RC to assess patient satisfaction with their experience with the WalkMORE program. These telephone surveys will be reviewed and approved by Lisa Hawthorne of the Patient Experience Office. On day 30 after discharge the RC will contact patients to conduct a brief quality of life survey and to collect data regarding clinical outcomes (ER visits, re-hospitalizations, and falls). Each telephone interview is expected to last approximately 10-15 minutes.
- Conditions
- Early Ambulation
- Being tested
- WalkMORE Group
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
WalkMORE GroupBehavioural
Hospitalized Internal Medicine patients will walk with trained volunteer coaches twice daily until hospital discharge
| Study group | Role | What they receive |
|---|---|---|
| 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. Receives: Behavioral: WalkMORE Group |
What is being measured
The primary outcome is the main question the study is designed to answer.
Patient Recruitment
Ability to recruit sufficient number of patients
Measured: 3 months
Secondary outcomes (1)
Patient Safety
Number of participants that experience a fall during the study intervention as reported by WalkMORE volunteer coaches.
Measured: 6 months
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted5 Dec 2017
- Study start6 Jun 2018
- Primary completion10 Dec 2018
- Study completion9 Jan 2019
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Early AmbulationStudies of the same condition, open and under way.
- More trials run by London Health Sciences Centre Research Institute OR Lawson Research Institute of St. Joseph'sThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Prevention
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Model description
- 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.
- Masking
- Single blind
- Who is masked
- Outcomes assessor
- Enrolment
- 150 participants (actual)
Sponsor and investigators
- Lead sponsor
- London Health Sciences Centre Research Institute OR Lawson Research Institute of St. Joseph's
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT03361891
- Sponsor's protocol ID
- ReDA 4304
- Status last verified
- Mar 2019
- First submitted
- 27 Nov 2017
- Last updated
- 15 Mar 2019
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Study at a glance
From the registry record, last updated by the sponsor on 15 Mar 2019. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- WalkMORE: Volunteer Walking Coach Program for Hospitalized Internal Medicine Patients, a Pilot Randomized Controlled Trial
- ClinicalTrials.gov ID
- NCT03361891
- Acronym / sponsor ID
- ReDA 4304
- Conditions
- Early Ambulation
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 150 participants (actual)
- Lead sponsor
- London Health Sciences Centre Research Institute OR Lawson Research Institute of St. Joseph'sUniversity, hospital or other
- Study start
- 6 Jun 2018 (actual)
- Primary completion
- 10 Dec 2018 (actual)
- Study completion
- 9 Jan 2019 (actual)
- First posted
- 5 Dec 2017 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
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.
Detailed description
WalkMORE is a single-center randomized controlled trial. The investigators will enroll up to 300 ambulatory patients admitted to the Internal Medicine unit (located on the 4th floor of University Hospital) who are >18 years of age and are anticipated to require a >48 hour hospital admission. A maximum of 6 patients will be assigned to each treatment arm at any given time. The investigators will recruit patients into the WalkMORE program over a 3-month period. The research coordinator (RC) will screen patients admitted to the Internal Medicine unit in the preceding 24-hour period to identify patients who fulfill the eligibility criteria. Patients will be randomized via REDCap (Research Electronic Data Capture), a secure, centralized web-based randomization module to:
- Standard of care; or
- 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 RC 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.
After obtaining written informed consent from eligible patients the RC will randomize patients, collect demographics, hospital admission details and perform a quality of life survey (EQ-5D) with all patients. All patients will be assigned a scientific pedometer on the day of randomization. The modus Health StepWatch™ is an activity monitor worn on the ankle via a velcro strap. It is a small, lightweight device that will count and record patients' steps throughout their hospital stay. The device is smaller than a deck of cards (7.5 x 5.0 x 2.0 cm) and weighs 38 grams and will be installed by the RC. The total number of steps recorded on the pedometer will be collected for each patient every day until hospital discharge. For patients randomized to the WalkMORE intervention arm, the total number of minutes walked with a volunteer coach will also be recorded for each session until discharge. Functional ability will be measured on the third day post-randomization and every three days thereafter until hospital discharge, using the Timed Up and Go test (patients will be asked to stand up from a chair, walk three metres, turn around, walk back to the chair, and sit). After hospital discharge the RC will follow up with patients for 2 brief telephone interviews. On day 3 after discharge, Patient Satisfaction surveys will be conducted by the RC to assess patient satisfaction with their experience with the WalkMORE program. These telephone surveys will be reviewed and approved by Lisa Hawthorne of the Patient Experience Office. On day 30 after discharge the RC will contact patients to conduct a brief quality of life survey and to collect data regarding clinical outcomes (ER visits, re-hospitalizations, and falls). Each telephone interview is expected to last approximately 10-15 minutes.
Study design
- Primary purpose
- Prevention
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (outcomes assessor)
- Number of arms
- 2
- Model description
- 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.
| Arm | Type | Receives |
|---|---|---|
| Control | No intervention | –Patients receive no intervention |
| WalkMORE group | Experimental | Behavioral: WalkMORE GroupWalkMORE 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. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (4 listed)
- 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
Key exclusion criteria (5 listed)
- 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.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| WalkMORE GroupHospitalized Internal Medicine patients will walk with trained volunteer coaches twice daily until hospital discharge | Behavioural | WalkMORE group |
Primary outcome
Patient Recruitment
Time frame: 3 months
Ability to recruit sufficient number of patients
1 secondary outcome
Patient Safety
Time frame: 6 months
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 15 Mar 2019.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
The record lists no contact. Use the official record to reach the sponsor.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing WalkMORE Group in people with Early Ambulation, run by London Health Sciences Centre Research Institute OR Lawson Research Institute of St. Joseph's at 1 site in Canada.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 4 inclusion and 5 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 15 Mar 2019. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Canada. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Patient Recruitment (time frame: 3 months). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 15 Mar 2019.