Improving Patient Walking During Hospitalization

Study at a glance

From the registry record, last updated by the sponsor on 27 Mar 2026. Recruitment status is as the sponsor reported it: confirm with the study team.

Official title

Preventing Hospital-Acquired Disability: An Intervention to Improve Older Adult Patient Ambulation

ClinicalTrials.gov ID

NCT04479943

Acronym / sponsor ID

2020-0010

Conditions

Early Mobility, Older Adults, Hospital Acquired Condition

Keywords

nursing care, hospitalization, aged, walking

Study type

Interventional

Recruitment status

Completed

Enrolment

765 participants (actual)

Lead sponsor

University of Wisconsin, MadisonUniversity, hospital or other

Collaborators

Agency for Healthcare Research and Quality (AHRQ)

Study start

2 Mar 2021 (actual)

Primary completion

27 Jan 2025 (actual)

Study completion

27 Jan 2025 (actual)

First posted

21 Jul 2020 (actual)

Results

Posted 27 Mar 2026

Clinical summary

The research question as the sponsor registered it. This describes what the study plans to test, not what it found.

Study design

Primary purpose

Prevention

Allocation

Randomised

Intervention model

Sequential

Masking

Single blind (participant)

Number of arms

3

Model description

This study uses an incomplete stepped wedge cluster randomized controlled trial. In the incomplete stepped wedge design, inpatient units are randomly sequenced into the intervention. A baseline (control period) and 2 follow up data collection periods (intervention and post intervention period) occur for each unit. Incomplete stepped wedge cluster randomized trials are novel study designs that are particularly beneficial for evaluating service delivery interventions using a pragmatic design, when evaluations need to be completed at a system or population level, or it is impractical or cost prohibitive to roll out an intervention across multiple units simultaneously.

Who may qualify

Ages

65 years and older

Sex

All

Healthy volunteers

Not accepted

Age groups

Older adult

Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.

Interventions

Primary outcome

1. Aim 1: Change in Gait Speed

   Time frame: Within 24 hours of hospital admission, Within 8 hours of hospital discharge, 3 months post-discharge; Up to 4 months total

   Gait Speed is a physical performance measure identified as a sensitive clinical indicator of health, mortality, healthcare utilization, and independence in ambulation, and is feasible to test in hospitalized older adults. A 4 meter walk test will be conducted on admission to the study, discharge from the hospital and at 3 months post discharge in the subjects home or the hospital or clinic. A trained member of the research team will conduct the gait speed test. Interrater reliability for the 4 meter walk test will be conducted between all members of the research team prior to collecting gait speed data on study participants. Change scores will be calculated as the difference among gait speeds measured at each time points.

2. Aim 1: Change in Self-report on Activities of Daily Living (ADL)

   Time frame: Within 24 hours of hospital admission, Within 8 hours of hospital discharge, 1 month post-discharge, 3 months post-discharge; 6 months post-discharge

   A trained member of the research team collected patients self-report of ADLs on admission to the study, discharge from the hospital, by phone at 1 month post intervention and 6 months post intervention, and in person at the 3 month post intervention visit using the Katz ADL Index. The Katz ADL Index is a self-report scale that measures six ADL on two levels (independent or requiring assistance of another). A score of 0-6 is possible, with higher scores indicating higher independence with ADLs and lower scores indicating higher dependence on others to perform ADLs. The scale demonstrates excellent reliability and predictive validity, and is sensitive to change in hospital settings. For the primary analysis, patients with a score of 6 were converted to a binary score of 1=Independent; all others were scored as 0=Dependent.

3. Aim 1: Change in Life Space Assessment

   Time frame: Within 24 hours of hospital admission, 1 month post-discharge, 3 months post-discharge; 6 months post-discharge

   The University of Alabama at Birmingham (UAB) Life Space Assessment (LSA) is a self-report scale of ambulation that measures spaces patients' move in, the frequency of moving into those spaces, and dependency in moving into those spaces. This scale has demonstrated reliability and predictive validity and sensitivity to change after hospital stay. Level scores are calculated by multiplying the life-space level (higher numbers indicate farther distances moved, e.g., 1-inside the home to 5-places outside of the person's town), degree of independence (higher scores indicate greater independence), and frequency of movement (higher scores equal greater frequency). Total scores range from 0 (totally bed-bound) to 120 (moved out of town every day without assistance). A trained member of the research team will collect patients self-report on Life Space. Change scores will be calculated as the difference among LSA ambulation measured at each time point.

4. Aim 2: Hospital Readmissions

   Time frame: 1 month post-discharge; 3 months post-discharge; 6 months post-discharge; Up to 7 months total

   Hospital readmissions were collected via patient self-report and via medical record review by a trained researcher from the study team. Patient readmission was coded as 0=not readmitted, 1=readmitted. Reported value for each cell reflects a model-based estimate of the probability of readmission, a type of least squares mean appropriate for a binary variable.

5. Aim 2: Emergency Department Visits

   Time frame: 1 month post-discharge; 3 months post-discharge; 6 months post-discharge; Up to 7 months total

   Emergency department (ED) visits will be collected via patient self report. Patient ED usage was coded as 0=no ED visit, 1=any ED visit. Reported value for each cell reflects a model-based estimate of the probability of an ED visit, a type of least squares mean appropriate for a binary variable.

6. Aim 2: Length of Hospital Stay

   Time frame: During hospital stay in the Pre-Intervention and Post-Intervention periods

   Length of hospital stay will be collected via patient medical record review by a nurse researcher from the study team.

7. Aim 2: Discharge Destination

   Time frame: Within 3 months post-discharge; Up to 4 months total

   Discharge destination (home, skilled nursing facility) was collected via patient medical record review by a nurse researcher from the study team. Patient discharge destination was coded as 1=discharged to home, 0=discharged to a skilled nursing facility. Reported value for each cell reflects a model-based estimate of the probability of discharge to home, a type of least squares mean appropriate for a binary variable.

8. Aim 3: Distance of Patient Ambulation

   Time frame: 6 months pre-intervention, during the 14-week intervention period, and 6 months post-intervention; up to 16 months total

   Unit level data on ambulation. Each week, the total distance walked on that unit by all patients on the unit was recorded. We report the average total weekly distance walked, using a model-based least squares mean. The number of participants analyzed is large because this measure is unit-level and includes all patients observed on the unit during the study period, not only those enrolled in the full study, and will double count patients who were observed during more than one week.

9. Aim 3: Barriers to Ambulation Survey

   Time frame: pre-intervention, post-intervention (up to about 20 weeks)

   Data collected from enrolled nursing staff via paper copies or online link before and after the intervention. The Barriers to Patient Ambulation Survey assesses the nurses opinions regarding ambulation of hospitalized patients within the past 2 weeks. It is scored from 0-100 with higher scores indicating increased barriers to ambulation.

10. Aim 3: Ambulation Culture Survey

    Time frame: pre-intervention, post-intervention (up to about 20 weeks)

    Data collected from enrolled nursing staff via paper copies or online link before and after the intervention. The Ambulation Culture Survey asks for opinions on ambulation culture. We report responses to the item, "How would you rate your unit/work area on patient care related to ambulation?" This item has a minimum score of 1 (Poor) and a maximum score of 5 (Excellent). Higher values represent a better outcome.

Results and safety

Loading the posted results from ClinicalTrials.gov…

Research links

• Official record on ClinicalTrials.govLast updated by the sponsor 27 Mar 2026.
• Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
• 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.

1 site in 1 country: see every site and its status.