Self-management of Chronic Mobility Limitations in MUHC Seniors

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT01593345
Recruitment Status : Completed
First Posted : May 8, 2012
Last Update Posted : December 21, 2015
Richard and Edith Strauss Foundation of Canada
Information provided by (Responsible Party):
Nancy Mayo, McGill University

Brief Summary:

The population is aging and chronic conditions, which are major causes of pain and mobility limitations, are on the rise, however, current access to physiotherapy is difficult. Knowledge on managing disability is substantial, but methods to translate into action are lacking. This project is designed to test a novel method of promoting function in vulnerable seniors and simultaneously develop awareness in the new generation of physiotherapists that they can have a proactive role in health promotion. The investigators are proposing a pilot project targeting both students and patients.

The research question are (1) What are the needs of vulnerable patients at the MUHC? Two groups will be targeted; newly discharged seniors (who will be eligible for an intervention) and cancer outpatients who will be surveyed only);(2) For a senior population at risk for physical deterioration, to what extent is a personalized mentoring approach to optimizing function and preventing disability through developing self-management skills more effective in improving outcomes than the provision of written material covering the same general content? (3) Does a mentoring experience with vulnerable seniors through development and teaching of a self-management program (comprised of education and support) produce meaningful positive changes in future clinicians' knowledge, skills and attitude towards modes of delivering physiotherapy services and promoting self-management in Canadian seniors?

There are two phases to this study: a survey and randomized controlled trial (RCT). The survey phase will identify mobility needs of two groups, newly discharged seniors and cancer outpatients. The needs assessment for newly discharged seniors will identify people eligible for the (RCT) component; the needs assessment for cancer outpatients will inform the development of interventions for this specific group. The RCT component will be piloted for recently discharged community dwelling seniors 70 years and older only.

A sample of 400 seniors recently discharged from the adult, general, hospital sites of the MUHC will be contacted for a needs assessment. From this pool, the investigators anticipate 100 will be eligible and 60 will be randomized, 30 to the mentor intervention and 30 to the control group. Participants will be followed-up for 6 months and assessments will be performed at 2 time points (baseline and 6 months). The main outcome is a standardized response ratio (SRR) estimated across all persons and measures. SRRs will be calculated for three groups of response variables: impairment/mobility measures, quality of life indicators, and health services outcomes.

In parallel, to determine cancer survivor needs, the investigators will contact 600 cancer survivors; as the investigators anticipate 400 will answer the survey. The analysis of this survey will consist of frequency of specific needs by diagnosis and treatment.

Condition or disease Intervention/treatment Phase
Seniors With Mobility Limitations Other: Mobility self-management with Mentor Other: Mobility self-management with guidebook Not Applicable

Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 60 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary Purpose: Treatment
Official Title: Promotion of Self-management of Chronic Mobility Limitations Among Vulnerable Seniors at the MUHC: Training the New Generation of Canadian Physiotherapists for This Role. Addendum: Planning Physiotherapy Services for Persons Treated at the MUHC for Cancer: A Needs Assessment
Study Start Date : February 2013
Actual Primary Completion Date : January 2015
Actual Study Completion Date : December 2015

Arm Intervention/treatment
Experimental: Mentor Other: Mobility self-management with Mentor
will be offered an evaluation and treatment plan supervised by a qualified physiotherapist, accompanied by written and visual material to enhance mobility self-management skills, supported by telephone mentoring by physiotherapy students in the Professional Master's program. The components of the mobility self-management program will target skill enhancement of each senior to identify their functional limitations, set realistic goals for mobility improvement, develop a mobility action plan, carry out the plan, and then re-assess their function and mobility. Mobility self-assessment, personalized goals, and the action plan will be incorporated into a personalized workbook that the senior can use to monitor their function profile and serve as a communication aid during health care encounters.

Active Comparator: Guidebook Other: Mobility self-management with guidebook
will be mailed an exercise guide targeting the key mobility limitations common in the elderly (range of motion, arm, leg, and core strength, and breathing). This guide has been developed and has been pilot tested on a small number of seniors and has been shown to be acceptable and feasible.

Primary Outcome Measures :
  1. Brief Pain Questionnaire [ Time Frame: 2 time points (baseline and 6 months) ]
  2. DASH [ Time Frame: 2 time points (baseline and 6 months) ]
  3. LEFS [ Time Frame: 2 time points (baseline and 6 months) ]
  4. RAND-MOS36 [ Time Frame: 2 time points (baseline and 6 months) ]
  5. Short Self Efficacy scale [ Time Frame: 2 time points (baseline and 6 months) ]

Secondary Outcome Measures :
  1. Health care utilization [ Time Frame: 2 time points (baseline and 6 months) ]
  2. Medication management [ Time Frame: 2 time points (baseline and 6 months) ]

Information from the National Library of Medicine

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Ages Eligible for Study:   70 Years and older   (Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • community dwelling seniors,
  • aged 70 years and older,
  • recently discharged from one of the adult general (MGH, RVH, Lachine) hospital sites,
  • with anyone of the following mobility limitations:

    1. Limitation in walking more than 1 block
    2. Limitation in going up 1 flight of stairs
    3. Unable to get groceries without help
    4. Unable to do housework (dishes, meals, vacuuming, making bed) without help
    5. Self-rated health fair or poor
    6. Pain
    7. Shortness of breath

Exclusion Criteria:

  • seniors discharged with orthopaedic or cardiac surgery, or
  • with stroke or myocardial infarction, as formal rehabilitation is part of the usual care plan for these conditions.

Also excluded will be people with dementia as identified on the medical chart.

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT01593345

Canada, Quebec
Lachine Hospital
Montreal, Quebec, Canada
Montreal General Hospital
Montreal, Quebec, Canada
Royal Victoria Hospital
Montreal, Quebec, Canada
Sponsors and Collaborators
McGill University
Richard and Edith Strauss Foundation of Canada
Principal Investigator: Nancy E Mayo, PhD McGill University

Additional Information:

Responsible Party: Nancy Mayo, Dr, McGill University Identifier: NCT01593345     History of Changes
Other Study ID Numbers: 2476
First Posted: May 8, 2012    Key Record Dates
Last Update Posted: December 21, 2015
Last Verified: December 2015

Keywords provided by Nancy Mayo, McGill University:
mobility limitations

Additional relevant MeSH terms:
Mobility Limitation
Signs and Symptoms