Design of an Early Exercise Program for Hospitalized Patients: "Let's Move".

Abstract

Background Hospital-associated deconditioning (HAD) affects up to 30% of older adults during acute hospitalization, leading to functional and cognitive decline and adverse long-term outcomes. Purpose To develop and pilot "Let's Move," an implementation-oriented early exercise program designed to support mobility in hospitalized patients. Methods An action-research study was conducted at a tertiary hospital in two stages: (i) program design based on an electronic health record (EHR) needs assessment and targeted protocol review; and (ii) pilot implementation among clinically stable adults aged ≥ 18 years, hospitalized for ≥ 48 h, without physiotherapy referral. Outcomes included Hopkins Highest Level of Mobility (JH-HLM) functional status, adherence, and safety, complemented by qualitative interviews and a focus group. Results In Stage 1, 1399 adult inpatients without rehabilitation referral were identified (median age, 65 years [IQR, 46-78]; length of stay, 3 days [IQR, 2-4]) with circulatory diseases predominating (57.18%). Among 26 participants enrolled in the pilot, 17 were evaluable for adherence, with 13 (76.5%) classified as adherent. Walking ≥ 75 m was the most frequent JH-HLM assessment category, no adverse events or in-hospital deaths occurred, and 25/26 participants (96.2%) achieved individualized goals. Qualitative findings supported relevance and feasibility and informed refinements, including sessions every 2 days and standardized educational materials. Discussion "Let's Move" is a structured early-mobilization program developed through action research that integrates brief patient education with low-intensity exercise for routine inpatient care. It provides a practical workflow to support early mobility and warrants broader evaluation to assess its effectiveness and scalability.