• Aaron C Hamilton, Natalie Lee, Mary Stilphen, Bo Hu, Sarah Schramm, Frederick Frost, Jacqueline Fox, and Michael B Rothberg.
• Department of Hospital Medicine, Cleveland Clinic, Cleveland, Ohio.
• J Hosp Med. 2019 May 1; 14 (5): 272-277.

BackgroundAmbulating medical inpatients may improve outcomes, but this practice is often overlooked by nurses who have competing clinical duties.ObjectiveThis study aimed to assess the feasibility and effectiveness of dedicated mobility technician-assisted ambulation in older inpatients.DesignThis study was a single-blind randomized controlled trial.SettingPatients aged ≥60 years and admitted as medical inpatients to a tertiary care center were recruited.InterventionPatients were randomized into two groups to participate in the ambulation protocol administered by a dedicated mobility technician. Usual care patients were not seen by the mobility technician but were not otherwise restricted in their opportunity to ambulate.MeasurementsPrimary outcomes were length of stay and discharge disposition. Secondary outcomes included change in mobility measured by six-clicks score, daily steps measured by Fitbit, and 30-day readmission.ResultsControl (n = 52) and intervention (n = 50) groups were not significantly different at baseline. Of patients randomized to the intervention group, 74% participated at least once. Although the intervention did not affect the primary outcomes, the intervention group took nearly 50% more steps than the control group (P = .04). In the per protocol analysis, the six-clicks score significantly increased (P = .04). Patients achieving ≥400 steps were more likely to go home (71% vs 46%, P = .01).ConclusionsAttempted ambulation three times daily overseen by a dedicated mobility technician was feasible and increased the number of steps taken. A threshold of 400 steps was predictive of home discharge. Further studies are needed to establish the appropriate step goal and the effect of assisted ambulation on hospital outcomes.

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