Introducing a clinically effective allied health rapid discharge team within a complex aged subacute in-patient cohort on a cost recovery basis: the Supported Patient centred Early Discharge (SPeED) initiative

2020 ◽  
Vol 44 (6) ◽  
pp. 931
Author(s):  
Peter Hough ◽  
Stephanie Gleeson ◽  
Nataliya Shkuratova ◽  
Freya Coker ◽  
Cylie Williams
Keyword(s):  
Older Adult ◽  
Allied Health ◽  
Functional Independence Measure ◽  
Early Discharge ◽  
Functional Independence ◽  
Care Patient ◽  
Historical Control ◽  
Control Group ◽  
Study Cohort ◽  
Early Supported Discharge

This case study reports the outcomes of an early supported discharge program. This model of care was trialled after Victoria introduced subacute weighted inlier equivalent separations funding to subacute in-patients in 2016. An allied health team (Supported Patient centred Early Discharge (SPeED)) managed patients suitable for assessment, intervention and early supported discharge (ESD). The SPeED cohort was compared to a matched historical control. Data included no advantage financially (NAF) days, length of stay (LOS), functional independence measure (FIM) scores and 30-day readmission rates. Staff and patient experiences were collected through surveys and call-back data. Regression analysis compared quantitative data, whereas a broad thematic approach compared qualitative data. There were no differences between the study cohort and historical control in age or sex (P>0.05). The SPeED cohort had lower median NAF days (F=−21.38; 95% confidence interval (CI) −37.70, −15.00; P<0.001), shorter LOS (F)=4.65; 95% CI −0.41, −0.02; P=0.034), fewer readmissions within 30 days (odds ratio 0.14; 95% CI −0.03, 0.68; P=0.014) and greater change in FIM scores during admission (F=4.20; 95% CI 0.16, 10.74; P=0.044). Staff morale was high in recognition of improved patient care. Patient satisfaction remained positive across the SPeED cohort and historical control group. The introduction of a dedicated allied health ESD team within a geriatric evaluation and management population is effective and enhances patient outcomes. What is known about the topic?Changing public subacute in-patient funding models places increased demand on providers to attain shorter patient LOS with finite staffing resources. Current published literature confirms the efficacy of rapid discharge programs in complex older adult cohorts only in the areas of stroke and respiratory conditions. What does this paper add?For clinicians and health service executives, this paper explores the potential to extend rapid discharge programs for complex older adult patients across a broad cohort of conditions through the introduction of a dedicated allied health rapid discharge team. It presents an intervention that seeks to balance patient-centred care with optimal funding and organisational outcomes. What are the implications for practitioners?The study findings highlight a promising opportunity for dedicated allied health rapid discharge teams within complex older adult in-patient populations to both optimise early patient preferred discharge and improve organisational financial performance.

scholarly journals Multidisciplinary versus physiotherapy-only weekend rehabilitation: A prospective cohort study

2021 ◽  
Author(s):  
Erin Caruana ◽  
David Rowell ◽  
Suzanne Kuys ◽  
Sandra G. Brauer
Keyword(s):  
Cohort Study ◽  
Length Of Stay ◽  
Prospective Cohort ◽  
Functional Independence Measure ◽  
Cost Savings ◽  
Functional Independence ◽  
Historical Control Group ◽  
Historical Control ◽  
Control Group ◽  
Rehabilitation Unit

Abstract Background This study aims to investigate the impact of multidisciplinary Saturday rehabilitation (MSR) on length of stay, functional independence, gait and balance when compared to a 6-day physiotherapy-only service in a pragmatic setting. An economic evaluation of the intervention conducted from the perspective of the healthcare provider is included.Methods A prospective cohort study with a historical control was conducted in an Australian private mixed rehabilitation unit to compare a multidisciplinary and physiotherapy-only 6-day rehabilitation service. Clinical outcomes included the Functional Independence Measure (Motor, Cognitive, Total), gait speed (10 Meter Walk test) and five balance measures (Timed Up and Go test, Step test, Functional Reach, Feet Together Eyes Closed and the Balance Outcome Measure of Elder Rehabilitation). Economic outcomes were rehabilitation unit length of stay and additional treatment costs.Results A total of 366 patients were admitted to the rehabilitation unit over two 20-week periods. The prospective cohort (MSR) had 192 participants and the historical control group (physiotherapy Saturday rehabilitation) had 174 participants). Participants in the historical control group had lower total and cognitive Functional Independence Measure scores (p < 0.078), and generally performed at a lower level on admission gait and balance measures compared to the prospective cohort. More participants in the prospective cohort attended weekend therapy, attending more sessions and spending more time in therapy compared to those in the historical control group (p < 0.012). After controlling for differences in admission Functional Independence Measure scores, length of stay was reduced by 1.39 ± 0.77 days. The economic evaluation estimated cost savings of $1,536 per patient. The largest savings were attributed to neurological patients $4,854. Traumatic and elective orthopaedic patients realised cost savings per admission of $2,668 and $2,180, respectively.Conclusions Implementation of MSR results in a more efficient service, enabling a greater amount of therapy to be provided over a shorter length of stay. The provision of a multi-disciplinary Saturday rehabilitation is potentially cost reducing for the treating hospital.Trial registration not applicable.

Effect of neuromuscular electrical stimulation on functional exercise capacity in patients undergoing cardiac surgery: A randomized clinical trial

2021 ◽  
pp. 026921552110709
Author(s):  
Telma Cristina Fontes Cerqueira ◽  
Manoel Luiz de Cerqueira Neto ◽  
Lucas de Assis Pereira Cacau ◽  
Amaro Afrânio de Araújo Filho ◽  
Géssica Uruga Oliveira ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Electrical Stimulation ◽  
Postoperative Period ◽  
Intervention Group ◽  
Neuromuscular Electrical Stimulation ◽  
Functional Independence Measure ◽  
Rectus Femoris ◽  
Functional Independence ◽  
Control Group ◽  
Electromyographic Activity

Objective To evaluate the effects of neuromuscular electrical stimulation on functional capacity of patients in the immediate postoperative period of cardiac surgery. Design A prospective, randomized controlled trial. Setting A cardiac surgery specialist hospital in Aracaju, Sergipe, Brazil. Subjects: Patients in the postoperative period of cardiac surgery. Intervention The control group received the conventional physiotherapy and the intervention group received neuromuscular electrical stimulation of the rectus femoris and gastrocnemius muscles bilaterally, applied for 60 min, twice a day for up to 10 sessions per patient, in the immediate postoperative period until postoperative day 5. Main measures The primary outcome was the distance walked, which was evaluated using the 6-min walk test on postoperative day 5. Secondary outcomes were gait speed, lactate levels, muscle strength, electromyographic activity of the rectus femoris and Functional Independence Measure, some of them evaluated on preoperative and postoperative period. Results Of 132 eligible patients, 88 patients were included and randomly allocated in two groups, and 45 patients were included in the analysis. No significant difference was found on the distance walked ( p = 0.650) between patients allocated in intervention group (239.06 ± 88.55) and control group (254.43 ± 116.67) as well as gait speed ( p = 0.363), lactate levels ( p = 0.302), knee extensor strength ( p = 0.117), handgrip strength ( p = 0.882), global muscle strength ( p = 0.104), electromyographic activity ( p = 0.179) and Functional Independence Measure ( p = 0.059). Conclusions Although the effects are still uncertain, the use of neuromuscular electrical stimulation carried out in five days didn't present any benefit on functional capacity of patients in the immediate postoperative period of cardiac surgery.

The Association of Judgement Ability and Functional Status in Older Adult Rehabilitation Inpatients

2018 ◽  
Vol 19 (3) ◽  
pp. 235-245 ◽  
Author(s):  
C. G. Quinn ◽  
L. A. Rabin ◽  
G. C. Sprehn
Keyword(s):  
Older Adults ◽  
Older Adult ◽  
Clinical Utility ◽  
Functional Independence Measure ◽  
Functional Independence ◽  
Practical Judgment ◽  
Physical Risk Factors ◽  
Patients At Risk ◽  
Global Cognition ◽  
Adult Rehabilitation

Purpose: Older adults have an increased likelihood of requiring rehabilitative care due to cognitive and physical risk factors. Research has found a link between executive functioning performance and functional outcomes; however, there is a dearth of research on the assessment of judgement ability. In the current pilot study, we investigated the clinical utility of the Test of Practical Judgment (TOP-J) in an older adult rehabilitation sample.Methods: Inpatients of mixed diagnoses (n= 25, mean age = 72.60) completed the TOP-J and Functional Independence Measure (FIM). We assessed TOP-J performance in the entire sample and in those with intact vs. impaired global cognition (on the Mini-Mental State Examination; MMSE). Correlational analyses were conducted between the TOP-J, MMSE and relevant FIM items.Results: TOP-J performance fell between the means typically observed in individuals with mild cognitive impairment and mild Alzheimer's disease. Participants with intact global cognition obtained significantly higher TOP-J scores than those with impaired global cognition. Moderate to strong positive correlations emerged between TOP-J, MMSE and FIM items of problem solving, comprehension and memory.Conclusions: Results provide support for the clinical utility and validity of the TOP-J among older adults in the rehabilitation setting. Administering the TOP-J may help identify patients at risk for future injury and facilitate role transitions.

scholarly journals Early home-supported discharge for patients with stroke in Portugal: a randomised controlled trial

2016 ◽  
Vol 31 (2) ◽  
pp. 197-206 ◽  
Author(s):  
Silvina Santana ◽  
José Rente ◽  
Conceição Neves ◽  
Patrícia Redondo ◽  
Nina Szczygiel ◽  
...  
Keyword(s):  
Stroke Unit ◽  
Controlled Trial ◽  
Functional Independence Measure ◽  
Functional Independence ◽  
Primary Outcome Measure ◽  
Control Group ◽  
Stroke Patients ◽  
Control Groups ◽  
Open Label

Objective: To evaluate an early home-supported discharge service for stroke patients. Design: We carried out a prospective, randomised, open-label, blinded-endpoint trial (allocation ratio of 1:1) with patients assigned to either an early home-supported discharge service or usual care. Setting: The study was undertaken in Aveiro, Portugal, between April 2009 and April 2013. Subjects: We included stroke patients aged 25–85 years admitted to the stroke unit with an initial Functional Independence Measure of up to 100, who gave informed consent. Interventions: Patients in the early home-supported discharge group began their rehabilitation intervention in the stroke unit and the early home-supported discharge team worked with them at home for a maximum of one month. Patients in the control group received usual services. Main measures: The primary outcome measure was the Functional Independence Measure at six months after stroke. Results: We randomised 190 patients of whom 34 were lost to follow-up. There were no significant differences (p > 0.5) in the average scores of Functional Independence Measure between the early home-supported discharge (69 ±22; mean ±SD) and the control groups (71 ±17) measured at baseline; and between the early home-supported discharge (107 ±20) and the control groups (107 ±25) measured at six months. The number of individuals with a low Functional Independence Measure score (<60) in the early home-supported discharge group compared with the control group was higher at admission (34/95 vs. 26/95) and lower at follow-up (2/74 vs. 5/78). Conclusions: It was feasible to implement early home-supported discharge procedures in a Southern European setting, but we have not shown convincing differences in disability at six months.

scholarly journals Effects of Constraint-Induced Therapy Versus Bilateral Arm Training on Motor Performance, Daily Functions, and Quality of Life in Stroke Survivors

2008 ◽  
Vol 23 (5) ◽  
pp. 441-448 ◽  
Author(s):  
Keh-chung Lin ◽  
Ya-fen Chang ◽  
Ching-yi Wu ◽  
Yi-an Chen
Keyword(s):  
Quality Of Life ◽  
Motor Performance ◽  
Functional Independence Measure ◽  
Proximal Part ◽  
Functional Independence ◽  
Control Group ◽  
Intensive Training ◽  
Hemiparetic Stroke ◽  
Bilateral Arm Training

Background and Objective. This study investigated the relative effects of distributed constraint-induced therapy (CIT) and bilateral arm training (BAT) on motor performance, daily function, functional use of the affected arm, and quality of life in patients with hemiparetic stroke. Methods. A total of 60 patients were randomized to distributed CIT, BAT, or a control intervention of less specific but active therapy. Each group received intensive training for 2 hours/day, 5 days/week, for 3 weeks. Pretreatment and posttreatment measures included the Fugl—Meyer Assessment (FMA), Functional Independence Measure (FIM), Motor Activity Log (MAL), and Stroke Impact Scale (SIS). The proximal and distal scores of FMA were used to examine separate upper limb (UL) elements of movement. Results . The distributed CIT and BAT groups showed better performance in the overall and the distal part score of the FMA than the control group. The BAT group exhibited greater gains in the proximal part score of the FMA than the distributed CIT and control groups. Enhanced performance was found for the distributed CIT group in the MAL, the subtest of locomotion in the FIM, and certain domains of the SIS (eg, ADL/IADL). Conclusion. BAT may uniquely improve proximal UL motor impairment. In contrast, distributed CIT may produce greater functional gains for the affected UL in subjects with mild to moderate chronic hemiparesis.

scholarly journals Evaluation of the influence of Active Rehabilitation camps on the functional abilities in persons with tetraplegia

2012 ◽  
Vol 26 (2) ◽  
pp. 51-56
Author(s):  
Lech Furmaniuk ◽  
Grażyna Cywińska-Wasilewska
Keyword(s):  
Preliminary Investigation ◽  
Functional Independence Measure ◽  
Functional Independence ◽  
Mean Value ◽  
Control Group ◽  
Functional Abilities ◽  
Motor Score ◽  
Group A ◽  
Active Rehabilitation ◽  
Group B

Abstract Introduction: Every year, about 400 new patients with tetraplegia arise in Poland. The solution ensuring the continuation of the rehabilitation process of such patients is the activity of non-governmental organizations associating disabled people. Among them Foundation of Active Rehabilitation (FAR) has greatest experience in rehabilitation of people after SCI. Annually, about 70 persons with tetraplegia participate in Active Rehabilitation (AR) camps. Aim of this study was to estimate the influence of AR camps on the functional abilities in persons with tetraplegia. Material and methods: 40 men with tetraplegia were examined. Subjects were divided into two groups: participants of AR camps (group A, n=20) and control (group B, n=20). TheASIA motor score was used to estimate the degree of upper limb impairment. Functional Independence Measure (FIM)was used to assess functional abilities. All subjects were assessed in the beginning of the study and reassessed after 8 days. Results: Both groups during preliminary investigation were homogeneous under regard the ASIA motor score as well as the results of FIM. During final investigations significant improvement of FIM was noted only in group A. The mean value of FIM significantly increased about 10.8 points. In group A significant correlation between FIM scores and ASIA motor score were found (p<0.001). Conclusion: Improvement of functional skills among patients with tetraplegia which participated in AR camps was observed. The highest improvement in FIM was observed among persons with a C6 tetraplegia. Obtained results (ceiling effect) through of examined persons from C7 tetraplegia were suggested the need of applying more sensitive tests.

scholarly journals Caída y factores demográficos y clínicos en adultos mayores: estudio de seguimiento

2021 ◽  
Vol 20 (1) ◽  
pp. 139-171
Author(s):  
Jack Roberto Silva Fhon ◽  
Rosalina Aparecida Partezani Rodrigues
Keyword(s):  
Older Adults ◽  
Older Adult ◽  
Mixed Model ◽  
Descriptive Analysis ◽  
Functional Independence Measure ◽  
Functional Independence ◽  
Wilcoxon Test ◽  
Clinical Factors ◽  
Chi Squared ◽  
State Examination

Objetivo: Analizar los factores demográficos y clínicos relacionados a las caídas en el adulto mayor que viven en el domicilio en un seguimiento de cinco años Método: Estudio cuantitativo y longitudinal retrospectivo realizado entre 2007/2008 y 2013 con 262 participantes brasileños con edad superior a 65 años. Se utilizaron los instrumentos de perfil demográfico, Mini Examen del Estado Mental, enfermedades autorreferidas, caídas y sus características, Escala de Fragilidad de Edmonton, Escala de Lawton y Brody y Medida de Independencia Funcional. Se realizaron análisis descriptivo, Chi cuadrado, prueba de Wilcoxon y prueba de modelos mixtos. Estudio aprobado por el comité de ética.Resultados: La mayoría era del sexo femenino, con edad entre 65 a 79 años, escolaridad entre 1 a 4 años y jubilados. La prevalencia de caídas fue de 21,8% y 37,8% en ambas evaluaciones. Se verificó que para cada enfermedad más que el adulto mayor tiene, aumenta la chance de sufrir una nueva caída. Además, para cada punto más en la escala de fragilidad, el adulto mayor tiene mayor chance de caer. Por otro lado, para cada medicamento a menos que el adulto mayor utiliza, presenta 10% menos chance de caer.Conclusión: La caída estuvo asociado a factores clínicos en el adulto mayor siendo necesario que el profesional de salud realice evaluaciones constantes para identificar este evento y sus desencadenantes. Objective: To analyze the demographic and clinical factors related to falls of older adults living at home in a five-year follow-up Materials and methods: Retrospective quantitative and longitudinal study conducted between 2007/2008 and 2013 with 262 Brazilians participants over 65 years old. We used the demographic profile, Mini-Mental State Examination, self-reported diseases, falls and their characteristics, Edmonton Frail Scale, Lawton and Brody Scale, Functional Independence Measure instruments. We performed descriptive analysis, Chi-squared, Wilcoxon test and mixed model test.Results: Most participants were women, aged between 65 to 79 years, schooling between 1 to 4 years and retired. The prevalence of falls was 21.8% and 37.8% in both evaluations. We verified that the chance of suffering a new fall increases for each additional disease of the older adult. In addition, for each point to more on the frail scale, the older adult has a greater chance of falling. On the other hand, for each medication withdrawn, the chance of falling decreases 10%.Conclusion: The fall was associated with clinical factors in older adults, therefore constant evaluations must be carried out to identify this event and its triggers. Objetivo: Analisar os fatores demográficos e clínicos relacionados à queda no idoso que vive no domicílio em um seguimento de cinco anos. Método: Estudo quantitativo e longitudinal retrospectivo realizado entre 2007/2008 e 2013 com 262 participantes brasileiros com idade superior de 65 anos. Foram utilizados os instrumentos de perfil demográfico, Mini Exame do Estado Mental, doenças autorreferidas, quedas e suas características, Escala de Fragilidade de Edmonton, Escala de Lawton y Brody y Medida de Independência Funcional. Realizaram-se análise descritivo, Qui quadrado, Teste de Wilcoxon e prova de modelos mistos. Estudo aprovado pelo comitê de ética.Resultados: A maioria era do sexo feminino, com idade entre 65 e 79 anos, escolaridade entre 1 a 4 anos e aposentados. A prevalência da queda foi de 21,8% e 37,8% em ambas as avaliações. Verificou-se que para cada doença a mais que o idoso sofre, aumenta a chance de sofrer uma nova queda. Ademais, para cada ponto a mais na escala de fragilidade, o idoso apresenta uma maior chance de cair. Por outro lado, para cada medicamento a menos que o idoso utiliza, presenta chance 10% menor de cair.Conclusão: A queda esteve associada a fatores clínicos no idoso sendo necessário que o profissional de saúde realize avaliações constantes com a finalidade de identificar esse evento e seus desencadeantes.

scholarly journals Efficacy of pulmonary rehabilitation in severe and critical-ill COVID-19 patients: a controlled study

2020 ◽  
Author(s):  
Gilbert Büsching ◽  
Zhongxing Zhang ◽  
Jean Paul Schmid ◽  
Thomas Sigrist ◽  
Ramin Khatami
Keyword(s):  
Pulmonary Rehabilitation ◽  
Rating Scale ◽  
Functional Independence Measure ◽  
Functional Independence ◽  
Controlled Study ◽  
Control Group ◽  
P Value ◽  
Fisher Exact Test ◽  
Rehabilitation Outcomes ◽  
Critical Ill

AbstractSevere and critical ill COVID-19 patients frequently need acute care hospitalization including mechanical ventilation at ICU due to acute respiratory distress. A high proportion of these patients will develop ICU-acquired weakness and a need for rehabilitation. However data on rehabilitation outcomes in these patients are scarce and the efficacy of rehabilitation remains essentially unclear. We therefore compared the rehabilitation outcomes between COVID-19 patients with pneumonia and other patients with common pneumonia to assess their rehabilitation efficacies.We retrospectively compared the performances of six-min walk test (6MWT), chronic respiratory questionnaire (CRQ), and functional independence measure (FIM) at the discharge from pulmonary rehabilitation between 51 Covid-19 patients and 51 patients with common pneumonia using linear regression controlled for baseline values at entrance, age, sex and cumulative Illness rating scale. Fisher exact test was applied to test whether the odd ratios (ORs) of non-improvement/improvement in 6MWT (>30-m) and CRQ (>10-point) at discharge were different between the two groups.Covid-19 patients had similar performances at discharge in 6MWT (P-value=0.14), CRQ (P-value=0.55), and 4.2-point higher (P-value=0.004) in FIM compared to the control group. No differences in the outcomes were found between severe and critical COVID-19 patients. The OR of non-improvement/improvement in 6MWT was 0.30 (P-value=0.13) between COVID-19 and control groups; but the odd of non-improvement in CRQ tended to be 3.02 times higher (P-value =0.075) in COVID-19 group.In-house rehabilitation is effective and suitable for COVID-19 patients irrespective from disease severity. The discrepancy of high physical improvement and relatively low gains of disease related quality of life compared to control patients with common pneumonia is however remarkable. Further studies need to evaluate whether this discrepancy is an indicator of chronic disease development.

scholarly journals The use of functionality scales in patients with Post-Polio Syndrome

2019 ◽  
Vol 6 (13) ◽  
pp. 367-379
Author(s):  
Aline Simão Helou ◽  
Anna Elisa Basto Ramos ◽  
Acary Souza Bulle Oliveira ◽  
Abrahão Augusto Juviano Quadros ◽  
Francis Meire Fávero
Keyword(s):  
Functional Status ◽  
Older Adult ◽  
Barthel Index ◽  
Nottingham Health Profile ◽  
Functional Independence Measure ◽  
Functional Independence ◽  
Health Profile ◽  
Functional Status Questionnaire ◽  
Katz Index

Post-Polio Syndrome (PPS) is a neurological disease, resulting in the decrease of the neuromuscular functions being characterized by a set of clinical manifestations that occur in individuals who had acute paralytic poliomyelitis. The patients with PPS begin to present new limitations on the performance of their ADLs and, at the same time, tend to ignore them, continuing their daily work with greater physical effort. The need for a functional evaluation is therefore necessary to find out where the commitments are in the ADLs and to help them without aggravating the degenerative PPS. To identify the main functional assessment scales used in individuals with PPS. A study review of the literature was performed on the functional scales used in patients with PPS described in the articles in the database. We found 12 functional scales in activities of daily living, as follows: Nottingham Health Profile (NHP), International Classification of Impairments, Disability's and Handicaps (ICIDH), Functional Status Questionnaire (FSQ), Physical Activity Scale for the Elderly (PASE), Sunnas ADL Index, Katz Index, Falls Efficacy Scale (FES), ADLs-Staircase, Barthel Index, Functional Independence Measure (FIM), Older Adult Resource Survey (OARS), and Self-Reporter ADL. None of the 12 scales mentioned in our study is validated for the use in patients with PPS, the most scales found in the literatures reviewed in this research were NHP and ICIDH. Therefore, we found 9 scales validated in Brazil, Barthel Index, Functional Independence Measure (FIM), Functional Status Questionnaire (FSQ), Falls Efficacy Scale (FES), Nottingham Health Profile (NHP), International Classification of Impairments, Disability's and Handicaps (ICIDH), Older Adult Resource Survey (OARS), Katz Index and Self-Reporter ADL.

Pedometers alone do not increase mobility in inpatient rehabilitation: a randomized controlled trial

2019 ◽  
Vol 33 (8) ◽  
pp. 1382-1390
Author(s):  
Amy Atkins ◽  
John Cannell ◽  
Christopher Barr
Keyword(s):  
Intervention Group ◽  
Functional Independence Measure ◽  
Inpatient Rehabilitation ◽  
Functional Independence ◽  
Functional Mobility ◽  
Step Count ◽  
Control Group ◽  
Randomized Controlled ◽  
Group A ◽  
Walking Velocity

Objective: To test if pedometers, as a motivational tool, could affect mobility outcomes in inpatient rehabilitation. Design: Randomized controlled clinical trial. Setting: Subacute hospital rehabilitation unit in Australia. Participants: A total of 78 participants with reduced mobility and clinician-determined capacity to improve. Interventions: Both groups received usual care. For the intervention group, a pedometer was worn on the hip with the step count visible to participant and recorded daily on an exercise log. For the control group, a pedometer fixed shut was worn on the hip and they recorded estimated distances walked on an exercise log. Main measures: Primary outcome was functional mobility – De Morton Mobility Index. Secondary outcome measures were walking velocity, functional independence measure, time spent upright and daily step count. Results: Significant improvements over time ( P < 0.001) in functional mobility, comfortable walking velocity and functional independence measure were not influenced by the intervention. The daily average upright time (hours) in the first week of intervention was different ( P = 0.004) between the intervention group (median, interquartile range (IQR): 1.67, 1.77) compared to the control group (median, IQR: 1.12, 0.82). Conclusion: Pedometers as a motivational tool without targets do not improve functional mobility in this population. Pedometers may improve daily upright time in this setting.

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