In-Hospital Mobility and Associated Factors
Senait Demeke *
Department of Physiotherapy, School of Medicine, University of Gondar Hospital, Gondar, Ethiopia.
Janakiraman Balamurugan
Department of Physiotherapy, School of Medicine, University of Gondar Hospital, Gondar, Ethiopia.
Getahun Asres Alemie
Department of Internal Medicine, School of Medicine, University of Gondar Hospital, Gondar, Ethiopia.
Eskedar Abebe
Department of Physiotherapy, School of Medicine, University of Gondar Hospital, Gondar, Ethiopia.
*Author to whom correspondence should be addressed.
Abstract
Background and Purpose: Immobility during hospitalization can lead to deleterious consequences and substantial decline in functional capacity, and even a rise in mortality rate has been reported. Determining and understanding varying levels of mobility, barriers to mobility, and associated factors during hospitalization will help in the development of successful health care interventions.
Study Design: An institution-based cross sectional study design was used to determine various levels of mobility (LOM) and to identify their associated factors and barriers in a single academic center in Ethiopia.
Methods: A 400 bed university teaching hospital and referral center for different health centers in and around Gondar was the study set-up. Four hundred twenty three adult patients of various wards admitted for different conditions were recruited by stratified sampling and assessed for in-hospital LOM using a previously validated scale.
Results: Four hundred twenty three subjects were included in this study (n=423, mean age 37±14, 45.2% male). One hundred fifty three (36.17%) of the patients were identified as having low LOM with median Modified Clinical Mobility Score (MCMS) of 12 (inter quartile range [IQR]: 6-15). Low in-hospital LOM was associated with multiple variables. Risk of low LOM was three-fold higher in male patients (p 0.001).Old age groups were associated with 4.7 times lower LOM, and symptoms like weakness, dyspnea or dizziness increase the risk of having low LOM compared to not having these symptoms (AOR=2.7, 95% CI = 1.39- 5.43). Other perceived barriers to mobility during hospitalization were pain (60.3%), followed by environmental factors (19.4%), and personal factors (14.7%). Symptoms, age, sex, length of stay at the hospital and presence of invasive medical lines, catheters, etc. are found to have significant association with low LOM at 95% CI.
Conclusion: More than one third of hospitalized patients were identified as having low LOM. Old age, presence of pain symptom, duration of stay at the hospital and invasive medical lines are significantly associated with a low level of mobility during hospitalization. We recommend early and effective management of contributing symptoms, and adjustment of the hospital environment for a better level of mobility. We posit early detection and classification of influential factors of mobility level is an important step towards developing successful intervention programs.
Keywords: Mobility barriers, hospitalization, in-hospital mobility, bed rest, movement order