Staying active with multimorbidity in acute hospital settings trial: a feasibility randomised controlled trial of allied health assistant mobility rehabilitation for patients with multimorbidity.

BACKGROUND: Older adults with multimorbidity are at risk of worsening disability in hospital. Delegating mobility rehabilitation to an allied health assistant (AHA), under the supervision of a physiotherapist, might increase rehabilitation opportunities for this group.

OBJECTIVE: Determine the feasibility of AHA mobility rehabilitation of inpatients with multimorbidity.

METHOD: We conducted an assessor-blinded, parallel, feasibility randomised controlled trial with qualitative component. Inpatients with multimorbidity on a general medical ward, who walked independently pre-admission, received mobility rehabilitation from an AHA or physiotherapist. Feasibility was evaluated according to demand, acceptability, practicality and implementation. Secondary outcomes included estimates of physical activity, discharge destination, 30-day readmission, functional activity and length of stay.

RESULTS: Sixty-one people (mean age 77 years) were randomised to receive rehabilitation from an AHA (n = 31) or physiotherapist (n = 30). AHA rehabilitation had high demand, with 79% of eligible participants recruited. Satisfaction with AHA rehabilitation was comparable with physiotherapy rehabilitation (acceptability). The AHA group received an average of 12 minutes (95% CI 6 to 17) more therapy per day than the physiotherapy group (implementation). The median cost of acute care was $1425 less in the AHA group and adverse events were comparable between groups (practicality). The AHA group may have walked more frequently (n = 155/236 days, 66% vs. n = 161/274 days, 59%) and their median length of stay was 3 days shorter than the physiotherapy group.

CONCLUSION: AHA mobility rehabilitation of older inpatients with multimorbidity was feasible on a general medical ward when delivered by experienced AHAs with additional training.