Effect of affordable technology on physical activity levels and mobility outcomes in rehabilitation: a protocol for the Activity and MObility UsiNg Technology (AMOUNT) rehabilitation trial.
People with mobility limitations can benefit from rehabilitation programmes that provide a high dose of exercise. However, since providing a high dose of exercise is logistically challenging and resource-intensive, people in rehabilitation spend most of the day inactive. This trial aims to evaluate the effect of the addition of affordable technology to usual care on physical activity and mobility in people with mobility limitations admitted to inpatient aged and neurological rehabilitation units compared to usual care alone.



A pragmatic, assessor blinded, parallel-group randomised trial recruiting 300 consenting rehabilitation patients with reduced mobility will be conducted. Participants will be individually randomised to intervention or control groups. The intervention group will receive technology-based exercise to target mobility and physical activity problems for 6 months. The technology will include the use of video and computer games/exercises and tablet applications as well as activity monitors. The control group will not receive any additional intervention and both groups will receive usual inpatient and outpatient rehabilitation care over the 6-month study period. The coprimary outcomes will be objectively assessed physical activity (proportion of the day spent upright) and mobility (Short Physical Performance Battery) at 6 months after randomisation. Secondary outcomes will include: self-reported and objectively assessed physical activity, mobility, cognition, activity performance and participation, utility-based quality of life, balance confidence, technology self-efficacy, falls and service utilisation. Linear models will assess the effect of group allocation for each continuously scored outcome measure with baseline scores entered as a covariate. Fall rates between groups will be compared using negative binomial regression. Primary analyses will be preplanned, conducted while masked to group allocation and use an intention-to-treat approach.



The protocol has been approved by the relevant Human Research Ethics Committees and the results will be disseminated widely through peer-reviewed publication and conference presentations.



ACTRN12614000936628. Pre-results.
The George Institute for Global Health, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia Discipline of Physiotherapy, Faculty of Health Sciences, The University of Sydney, Sydney, New South Wales, Australia.
Leanne
L
Hassett
Department of Rehabilitation, Aged and Extended Care, Flinders University, Adelaide, South Australia, Australia.
Maayken
M
van den Berg
The George Institute for Global Health, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.
Richard I
RI
Lindley
Department of Rehabilitation, Aged and Extended Care, Flinders University, Adelaide, South Australia, Australia.
Maria
M
Crotty
Discipline of Occupational Therapy, Faculty of Health Sciences, The University of Sydney, Sydney, New South Wales, Australia.
Annie
A
McCluskey
Department of Public & Occupational Health and EMGO+ Institute for Health and Care Research, VU University Medical Center Amsterdam, Amsterdam, The Netherlands School of Public Health/Sydney Medical School The University of Sydney, Sydney, New South Wales, Australia.
Hidde P
HP
van der Ploeg
Stuart T
ST
Smith
Faculty of Arts and Business, University of the Sunshine Coast, Maroochydore DC, Queensland, Australia Physiotherapy Department and Department of Aged Care and Rehabilitation, Bankstown-Lidcombe Hospital, South Western Sydney Local Health District, Sydney, New South Wales, Australia.
Karl
K
Schurr
Department of Rehabilitation, Aged and Extended Care, Flinders University, Adelaide, South Australia, Australia.
Maggie
M
Killington
Faculty of Design, Architecture and Building, University of Technology Sydney, Sydney, New South Wales, Australia.
Bert
B
Bongers
School of Public Health/Sydney Medical School The University of Sydney, Sydney, New South Wales, Australia.
Kirsten
K
Howard
Department of Epidemiology and Preventive Medicine/Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia.
Stephane
S
Heritier
Discipline of Speech Pathology, Faculty of Health Sciences, The University of Sydney, Sydney, New South Wales, Australia.
Leanne
L
Togher
The George Institute for Global Health, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.
Maree
M
Hackett
Physiotherapy Department and Department of Aged Care and Rehabilitation, Bankstown-Lidcombe Hospital, South Western Sydney Local Health District, Sydney, New South Wales, Australia.
Daniel
D
Treacy
School of Physiotherapy Faculty of Health Sciences/Australian Catholic University, Sydney, New South Wales, Australia.
Simone
S
Dorsch
Physiotherapy Department and Brain Injury Rehabilitation Unit, Liverpool Hospital, South Western Sydney Local Health District, Sydney, New South Wales, Australia.
Siobhan
S
Wong
Faculty of Medicine and Health Sciences, Macquarie University, Sydney, New South Wales, Australia.
Katharine
K
Scrivener
The George Institute for Global Health, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.
Sakina
S
Chagpar
Department of Rehabilitation, Aged and Extended Care, Flinders University, Adelaide, South Australia, Australia.
Heather
H
Weber
Consumer Advisor, Sydney, New South Wales, Australia.
Ross
R
Pearson
The George Institute for Global Health, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.
Catherine
C
Sherrington
D000058:Accidental Falls / Q000706:statistics & numerical data*; D000368:Aged; D001315:Australia; D002985:Clinical Protocols; D015444:Exercise; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D007297:Inpatients; D016014:Linear Models; D008297:Male; D051346:Mobility Limitation; D000066530:Neurological Rehabilitation / Q000379:methods*; D011788:Quality of Life; D020377:Self Efficacy; D013672:Technology; D018910:Video Games
mobility; physical activity; protocol; technology