Abstract
Objective
Mobility interventions have been shown to mitigate functional decline in various clinical
populations; however, the effects of mobility programs in older hospitalized patients
are unclear. The objective of this study was to determine the effects of unstructured
mobility programs on physical activity, physical function, length of stay (LOS), and
quality of life (QOL) in older (≥60 years) general medicine inpatients.
Design
In this systematic review and meta-analysis, we systematically searched MEDLINE, Embase,
CINAHL, and AMED databases from inception to March 2020, plus hand screening references
of relevant studies.
Setting and Participants
We included randomized controlled trials (RCTs) and quasi-experimental studies assessing
the effects of mobility programs compared to usual care in older adults admitted to
general medicine units.
Measures
Teams of 2 reviewers independently extracted data, assessed risk of bias, and evaluated
quality of evidence. Where study population, intervention, and outcomes were similar,
results from RCTs were combined by meta-analysis.
Results
Three RCTs and 10 quasi-experimental studies met eligibility criteria. Interventions
mainly included ambulation and staff, patient, or caregiver education. Meta-analyses
showed that mobility interventions had a moderate effect on physical activity [step
count standardized mean difference 0.60, 95% confidence interval (CI) 0.23-0.97] and
a nonsignificant effect on LOS (mean difference –0.36, 95% CI –1.92 to 1.21), both
favoring mobility. Narrative synthesis showed consistent evidence for improvement
in physical function, potential decrease in LOS, and no increase in adverse events
with mobility interventions.
Conclusions and Implications
Unstructured mobility interventions in general medicine units may improve older hospitalized
patients’ physical activity and physical function; however, the quality of evidence
was low. More RCTs are needed to evaluate the effectiveness of mobility interventions,
particularly on LOS and QOL.
Keywords
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Article info
Publication history
Published online: January 09, 2021
Footnotes
This research was undertaken, in part, thanks to funding from the Canada Research Chairs Program, Canada (Grant ID: 950 – 233142).
The authors declare no conflicts of interest.
Identification
Copyright
© 2020 AMDA - The Society for Post-Acute and Long-Term Care Medicine.
