The Southampton Mobility Volunteer programme to increase physical activity levels of older inpatients: a feasibility study (SoMoVe) Dr Stephen Lim Specialist Registrar in Geriatric Medicine NIHR CLAHRC Clinical Research Fellow Chief investigator: Dr Helen Roberts, Associate Professor in Geriatric Medicine

Background 45 previously independent older male inpatients, (mean age of 74yrs) typically spent only 43 minutes per day in an upright position. 83% of their hospital stay was spent lying in bed. During the office hours of 9am to 5pm, the median duration spent standing or walking was 25 minutes (UHS). Low mobility among older people in hospital is associated with poor health outcomes : worsening physical function, increasing dependence in activities of daily living, increased admission to nursing home and increased mortality.

The implementation of a mobility or exercise programme for older people in the acute care setting is feasible with promising outcomes including improvement in physical function, shorter hospital stay and reduced nursing home admissions

Research question Is it feasible to train volunteers to encourage hospitalised older people to be more active?

Methods Inclusion criteria Patients age 70 years and above; (Ward G7, G8 and G9) Able to walk prior to hospital admission; No medical reasons to stop them from walking or exercising; and Able to give consent.

Methods 1.Baseline physical activity assessment 2.Volunteer training 3.Intervention phase 4.Acceptability

Baseline data collection 50 patients Measure physical activity levels using 1. GENEActiv 2. StepWatch Activity Monitor Validation of device Feb – July 2016

Volunteer training Role of the volunteers Introduce themselves to the staff members on the wards Enquire suitability of patients for intervention with nurses Hand washing Introducing themselves to patients and offer to encourage patients mobilise or do bedside exercises Clearing bed space to mobilise patient safely Check for appropriate footwear Get mobility aid if required Encourage patients to mobilise as allowed or as patient able Bed or chair based exercise for patients who are not independently mobile Know when and where to get help Caring for the falling patient Returning patient back to bed space, including rearranging bedside table, call buzzer within reach Hand washing Log activity

Volunteer training

Training session with the therapy and research team Volunteers supervised on the wards and competencies assessed Ongoing support from research team and ward therapist Aim to train about 20 volunteers

Intervention Aim to begin in August 2016 Encourage patients to keep active (walk or chair based exercises) twice a day for about 15minutes each session. Physical activity levels measured Assessment of cognition, mood, quality of life, physical function measures

Preliminary results 33 patients (18 males) Mean age 86.7 years Both devices have been well-tolerated by patients. Median device wear time: 3 days for both devices 2 patients wear unable to wear the SAM due to peripheral oedema or vascular disease. 1 patient declined to wear the GENEActiv as he was not used to wearing watches. Median daily step count: 1187steps over 24 hours

Feasibility Volunteers recruited, trained, and retained Adherences to activity sessions Volunteer demographics Adverse events Report on the training programme

Acceptability Focus groups and interviews Patients Volunteers Therapists Nurses

Any questions?