title: Assisted early mobility for hospitalized older veterans: preliminary data from the STRIDE program.
abstract: An important contributor to hospital-associated disability is immobility during hospitalization. Preliminary results from STRIDE, a clinical demonstration program of supervised walking for older adults admitted to the hospital with medical illness, are reported. The STRIDE program consisted of a targeted gait and balance assessment by a physical therapist, followed by daily walks supervised by a recreation therapy assistant for the duration of the hospital stay. To examine program effectiveness, STRIDE participants (n = 92) were compared with individuals referred but not enrolled (because of refusal or because program was at capacity, n = 35). Median length of stay was 4.7 days for STRIDE participants and 5.7 days for individuals receiving usual care (P = .31). There was one inpatient fall in each group (not associated with a STRIDE walk). Overall, 92% of STRIDE participants were discharged to home (rather than a skilled nursing facility (SNF)) compared to 74% of individuals receiving usual care (P = .007). Thirty-day emergency department visit rates and readmission rates were not significantly different between the two groups. STRIDE, a supervised walking program for hospitalized older adults, was feasible and safe, and program participants were less likely to be discharged to a SNF than a demographically similar comparison group. STRIDE is a promising interdisciplinary approach to promoting mobility and improving outcomes in hospitalized older adults.
authors.affiliation: Center for Health Services Research in Primary Care, Veterans Affairs Medical Center, Durham, North Carolina; Geriatrics Research, Education and Clinical Center, Veterans Affairs Medical Center, Durham, North Carolina; Division of Geriatrics, Department of Medicine, Duke University, Durham, North Carolina; Center for the Study of Aging and Human Development, Duke University, Durham, North Carolina.
authors.forename: S Nicole
authors.initials: SN
authors.lastname: Hastings
authors.forename: Richard
authors.initials: R
authors.lastname: Sloane
authors.forename: Miriam C
authors.initials: MC
authors.lastname: Morey
authors.forename: Juliessa M
authors.initials: JM
authors.lastname: Pavon
authors.forename: Helen
authors.initials: H
authors.lastname: Hoenig
mesh_terms: D000203:Activities of Daily Living / Q000145:classification; D000368:Aged; D000369:Aged, 80 and over; D004185:Disability Evaluation; D004434:Early Ambulation; D005260:Female; D005684:Gait; D006295:Health Resources / Q000706:statistics & numerical data; D006760:Hospitalization; D006787:Hospitals, Veterans / Q000706:statistics & numerical data; D006801:Humans; D007902:Length of Stay; D008297:Male; D065228:Non-Randomized Controlled Trials as Topic; D009657:North Carolina; D010351:Patient Discharge; D010359:Patient Readmission; D004856:Postural Balance; D015397:Program Evaluation; D057173:Recreation Therapy; D014600:Utilization Review / Q000706:statistics & numerical data; D014728:Veterans; D016138:Walking
keywords: acute care; mobility; models of care