STRIDE
Trial question
What is the effect of implementation of a supervised walking program in hospitalized community-dwelling older adults?
Study design
Multi-center
Open label
RCT
Population
Characteristics of study participants
3.0% female
97.0% male
N = 12863
12863 patients (423 female, 12440 male).
Inclusion criteria: adult patients ≥ 60 years of age who were community-dwelling and hospitalized for ≥ 2 days.
Key exclusion criteria: index hospital stay < 2 business days; current hospitalization; current high-risk suicide flag in medical record; diagnosis of cognitive impairment or dementia.
Interventions
N=6722 STRIDE (implementation of a supervised walking program known as assisted early mobility for hospitalized veterans).
N=6141 usual care (pre-implementation before STRIDE program).
Primary outcome
Discharge to a skilled nursing facility
8%
13%
13.0 %
9.8 %
6.5 %
3.3 %
0.0 %
STRIDE
Usual
care
Significant
decrease ▼
NNT = 20
Significant decrease in discharge to a skilled nursing facility (8% vs. 13%; OR 0.6, 95% CI 0.5 to 0.8).
Secondary outcomes
No significant difference in length of hospital stay (6.92 days vs. 6.58 days; RR 1.05, 95% CI 0.97 to 1.15).
No significant difference in physical function-disability, measured by Late Life Function and Disability Instrument (67.31 vs. 65.99; MD 1.32, 95% CI -2.7 to 5.33).
No significant difference in physical function-limitations, measured by Late Life Function and Disability Instrument (65.67 vs. 64.12; MD 1.56, 95% CI -3.14 to 6.25).
Conclusion
In adult patients ≥ 60 years of age who were community-dwelling and hospitalized for ≥ 2 days, STRIDE was superior to usual care with respect to discharge to a skilled nursing facility.
Reference
Susan N Hastings, Karen M Stechuchak, Ashley Choate et al. Effects of Implementation of a Supervised Walking Program in Veterans Affairs Hospitals : A Stepped-Wedge, Cluster Randomized Trial. Ann Intern Med. 2023 Jun;176(6):743-750.
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