Goal-Directed Mobility of Medical Inpatients–A Mini Review of the Literature

BACKGROUND: Inpatients spend most of their hospitalization in bed, which can lead to negative physical, social, and psychological outcomes, especially in the geriatric population. Goal-directed mobilization involves setting mobility goals with patients and care teams working together toward achieving these goals. METHODS: Three different platforms (SCOPUS, Ovid Medline, PubMed) were searched. Search terms included “goal-directed,” “goal-attainment” or “goal-setting,” and “inpatient” or “hospitalization” and “mobility” or “mobilization.” Articles were included if mobility goals were set in acutely hospitalized adults. Studies were excluded if only covering specific illness or surgery. RESULTS: One Hundred Seventy three articles were screened for inclusion by two independent reviewers. In the final analysis, 13 articles (5 randomized controlled trials, 2 Post-hoc analyses, 3 quality-improvement projects, 1 pre-post two group analysis, 1 comment and 1 study protocol) were assessed. Goal-directed mobilization improved mobility-related outcomes, i.e., level of mobilization, activity, daily walking time and functional independence. Readmissions, quality of life, discharge disposition and muscle weakness were not significantly altered and there was conflicting evidence regarding length of stay and activities of daily living. CONCLUSION: There is a lack of evidence of goal-directed mobilization on relevant outcomes due to the low number of studies in the field and the study design used. Further research on goal-directed mobility should use standardized mobility protocols and measurements to assess mobility and the effects of goal-directed mobility more accurately and include broader patient populations.