| Interventions |
Exercise arm
TIDieR item 1: (brief name: provide the name or a phrase that describes the intervention): mobility programme. TIDieR item 2: (why: describe any rationale, theory or goal of the elements essential to the intervention): mobility programme designed to address the evidence that older adults who experience low mobility during hospitalisation are at substantially increased risk of serious declines in strength and function, which may lead to long‐term mobility disability. TIDieR item 3: (what (materials): describe any physical or informational materials used in the intervention, including those provided to participants or used in intervention delivery or in training of intervention providers): a rolling walker was provided if needed. Gait belts were used to ensure safe ambulation. A diary was provided to participants to record their physical activity, see item 9. TIDieR item 4: (what (procedures): describe each of the procedures, activities or processes (or a combination) used in the intervention, including any enabling or support activities): protocol for the mobility programme began with assisted sitting, then standing, progressing to weight shifting, stepping in place and ambulation as tolerated with the assistance of the research assistant. Additionally, a behavioural intervention was used to encourage additional physical activity outside supervised intervention. TIDieR item 5: (who provided: for each category of intervention provider (e.g. psychologist, nursing assistant), describe their expertise, background and any specific training given): all members of the research team who transferred and walked with participants received in‐depth training in safe patient handling techniques by physical therapists. Proficiency and competency were documented using objective standards. TIDieR item 6: (how: describe the modes of delivery (such as face‐to‐face or by some other mechanism, such as Internet or telephone) of the intervention and whether it was provided individually or in a group): participants seen individually, face‐to‐face by the research assistant. TIDieR item 7: (where: describe the type(s) of location(s) where the intervention occurred, including any necessary infrastructure or relevant features): medical ward. TIDieR item 8: (when and how much: describe the number of times the intervention was delivered and over what period of time including the number of sessions, their schedule, and their duration, intensity or dose): exercise was supervised up to twice per day for 15–20 minutes, 7 days per week. Although participants were encouraged to walk at each session, they could refuse any or all sessions. The research assistant attempted to make ≥ 3 visits for each scheduled walk. If a participant was away at a test or busy with another healthcare professional, the research assistant returned at a later time to walk with the participant. In addition to the mobility protocol, a behavioural intervention strategy was integrated to encourage participants to increase time spent out of bed. TIDieR item 9: (tailoring: if the intervention was planned to be personalised, titrated or adapted, then describe what, why, when and how): the level of out‐of‐bed activity was dependent on the individual participant and incorporated activities participants were deemed able to do independent of cueing or assistance during each walking session. The participant and research assistant set daily goals regarding the amount of time the participant would try to spend out of bed. The participants physical activity diary was used by the research assistants to reinforce positive behaviour and to set goals for the following day. In addition to goal setting, participants were encouraged to discuss any barriers to mobility they were experiencing. Using an interview guide, the research assistant asked about mobility challenges and prompted participants to develop potential solutions to these challenges. TIDieR item 10: (modifications: if the intervention was modified during the course of the study, describe the changes (what, why, when and how)): not specified. TIDieR item 11: (how well (planned): if intervention adherence or fidelity was assessed, describe how and by whom, and if any strategies were used to maintain or improve fidelity, describe them): to assist in self‐monitoring of out‐of‐bed mobility, the participants were provided with a diary that could be used to document each time they sat up or walked. TIDieR item 12: (how well (actual): if intervention adherence or fidelity was assessed, describe the extent to which the intervention was delivered as planned): the group completed 122 (51.3%) of the potential 238 walks. Reasons for lack of completion included participant refusal 18.9%, participant unavailable because of tests or procedures 16.4%, staff not available 11.3%, and other 2%. Although 45 walks were refused during the study, 28 refusals (62.2%) came from 4 participants. For the behavioural intervention component, which included goal setting and discussion of mobility barriers, the MP group completed 108 (80%) of the 135 visits.
Control arm
TIDieR item 1: usual care. TIDieR item 2: not specified. TIDieR item 3: participants were provided with a diary that looked identical to those provided to the participants in the mobility programme group. The participants in the control arm were asked to document frequency of visitors, both family and healthcare professionals. TIDieR item 4: the participants received visits by the research assistant to control for the daily attention that intervention group received. Physicians were able to order PT services. TIDieR item 5: not specified. TIDieR item 6: participants seen individually, face‐to‐face by the research assistant. TIDieR item 7: medical ward. TIDieR item 8: the visits from the research assistant were approximately 15–20 minutes long and occurred up to twice per day 7 days per week. TIDieR item 9: not specified. TIDieR item 10: not specified. TIDieR item 11: not specified. TIDieR item 12: the group completed 184/223 (82.5%) visits.
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