Impact of inpatient mobility on outcomes in Parkinson's disease

The Parkinson's Foundation (PF) Hospital Care Recommendations include early mobilization of inpatients with PD at least 3 times daily. The Move to Heal Program is an initiative to mobilize inpatients frequently and safely. We seek to determine if PD patients in the mobility group (MG) with ≥3 mobilizations daily had better outcomes than the no-mobility group (NMG) with <3 mobilizations daily.

This retrospective study evaluated inpatients admitted ≥24 h, excluding obstetrics, rehabilitation, or >24 h in an ICU, between February-September 2023. Patients in the NMG or MG were propensity score matched based on age, gender, and comorbidities. Differences in characteristics were assessed using chi-square or fishers exact test, and independent t-tests. Outcomes were evaluated using mixed effects models with the covariates of mobilization, PD, admission type, payor, and Activity Measure for Post-Acute Care score.

We identified 24,943 controls and 612 people with PD. After matching, there were 6392 controls and 153 PD in the NMG and the same number in the MG. Length of stay (LOS) with mobility was 0.79-day shorter in PD (p = 0.019) and 0.35-day shorter in controls (p < 0.001). In PD but not controls, model estimated probability of home-to-home discharge was higher in the MG than NMG at 65 % versus 50 %, respectively (p = 0.004).

Inpatients with PD with at least 3 mobilizations daily had a shorter LOS and higher probability of home-to-home discharge, lending support to PF Hospital Care Recommendations. Prospective studies in larger PD cohorts will be necessary to better characterize the benefits of mobilization.