Mobility Programs for the Hospitalized Older Adult: A Scoping Review

Abstract

Objectives: This scoping review (a) describes programs to improve mobility in hospitalized adults and (b) determines the methods used to measure mobility. Method: The Joanna Briggs Institute Methodology for Scoping Reviews was used to conduct this review. Results: Our findings suggest that using a multidisciplinary approach may be the most effective way to promote mobility in hospitalized older adults. Most studies did not articulate how physical activity was measured, indicating that more research is needed. Discussion: The literature shows that implementation of protocols designed to improve the early and regular implementation of physical mobility activities improves the health outcomes of hospitalized older people. Costs associated with healthcare utilization are also reduced, including hospital length of stay. Mobility programs that quantified mobility through validated measurement tools or accelerometers are the most promising as they provide feedback that reinforces progress of the patient and the expected benefits of early mobility.

Recommendations for older adults’ physical activity and sedentary behaviour during hospitalisation for an acute medical illness: an international Delphi study

“…At the individual level, complexities can relate to the heterogeneity of acute medical conditions (clinical stability and the safety of exercise in different populations) and levels of independence seen in older adults. There is some evidence for mobilisation and exercise programs (including within models of care such as 'Acute Care for Elders') [21][22][23][24] but there remain few interventions [25][26][27] to address low mobility and high levels of SB for people in hospitals [28].…”

Predictors of physical activity in older adults early in an emergency hospital admission: a prospective cohort study

“…There has been an increase in clinical [11] and research focus [6,12,13] to increase mobilisation on acute medical and geriatric wards, with an emphasis on protocols designed to improve the early and regular implementation of physical mobility activities to improve the health outcomes of hospitalised older people [14].…”

Early Mobility After Fragility Hip Fracture: A Mixed Methods Embedded Case Study

“…It was articulated that the goal is to "make sure each patient gets that bit of activity every day", essentially maintaining their earliest achievements until the patient is discharged to rehab; the ideology of mobility for 'improvement' of patient outcomes is not explicit nor expected. Nursing reported their primary activity goal of getting a patient out of bed and up to chair at least once daily, which literature describes as a low level of mobility [37]. Nursing staff participants articulated balancing workload and perceived time required as a limitation to walking patients, a nding echoed in other studies [37].…”

“…Nursing reported their primary activity goal of getting a patient out of bed and up to chair at least once daily, which literature describes as a low level of mobility [37]. Nursing staff participants articulated balancing workload and perceived time required as a limitation to walking patients, a nding echoed in other studies [37].…”