Implementing in hospital technology-assisted mobility initiatives: A scoping review

Hospitalized patients are typically inactive, though evidence highlights the effectiveness of mobility-enhancing interventions in improving health outcomes. Technology-assisted approaches are increasingly used to encourage patient movement.

This scoping review examines technology-assisted initiatives designed to promote physical activity in hospitalized adults and explores implementation strategies used to facilitate these initiatives.

The Arksey and O'Malley's 2005 framework was used. Studies were identified through searches of MEDLINE, EMBASE, CINAHL, Scopus, and Cochrane trials. Bibliographies of included studies were searched. Characteristics of technology-assisted interventions and implementation strategies used were extracted, categorized, and analyzed for frequency.

Thirty papers representing 28 unique initiatives were identified from 6049 articles. The technology used were wearable step or activity counters (20), exergames (6), mobile ambulation reminders (3), and applications for in-bed exercises (1). Five implementation strategies reported from three studies were coded using the Expert Recommendations for Implementing Change: identifying and preparing champions, facilitating relay of clinical data, conducting educational meetings, developing and distributing educational materials. Eight behavior change techniques were reported: encouragement, collaborative goal setting, increasing daily goals, progress tracking, visual data display, patient education, environmental modification and physical therapist support.

The implementation of technology-assisted mobility interventions in hospitals to enhance patient mobility is emerging. Applying implementation and behavioral science frameworks may enhance effectiveness. Future studies are required to evaluate implementation strategy outcomes and to examine patient and clinician experiences to inform intervention adaptation and to facilitate integration into routine clinical hospital ward/unit practice.