Assistant-led mobility rehabilitation appears feasible

Trained allied health assistants safely delivered feasible inpatient mobility rehabilitation.
*Feasibility randomized controlled trial; Level 2 (OCEBM).

Citation

Snowdon DA, Wang YT, Callisaya ML, et al. Age and Ageing. 2026;55:afag279. doi:10.1093/ageing/afag279

Background

Older hospitalized adults with multiple chronic conditions often lose mobility and independence. Physiotherapists may have limited time, so supervised rehabilitation by trained assistants could increase activity.

Patients

Sixty-one general medical inpatients, mean age 77 years, with at least two chronic conditions and independent walking before admission. Exclusions included unstable condition, need for specialized physiotherapy, major surgery, or acute stroke.

Intervention

Mobility rehabilitation delivered by an experienced, additionally trained allied health assistant under physiotherapist supervision.

Control

Usual mobility rehabilitation delivered by a physiotherapist.

Outcome

Primary: feasibility, including acceptability, demand, delivery, cost, and safety. Secondary: walking, discharge, readmission, falls, length of stay, and function using the Modified Iowa Level of Assistance scale (0 to 42; higher is worse).

Follow-up Period

Hospital discharge and 30 days after discharge.

Results

OutcomeKey finding
Recruitment79% of eligible patients enrolled.
Direct therapy time11.5 more minutes/day with assistant care (95% CI 6.0 to 17.1).
Walking less than 5 meters66% of hospital days with assistant care versus 59% with physiotherapist care.
Acute hospital stayMedian 11 versus 14 days; difference 3 days (CI not reported).
Acute care costMedian AUD $1425 lower per patient (CI not reported).

AUD: Australian dollars.

Analyses followed intention-to-treat principles. The control was current usual care. No intervention-related adverse events occurred.

Limitations

Small single-site feasibility trial, not powered to prove patient benefit. Staff knew group assignment, which may have influenced walking records and discharge planning. Only 8% of screened patients were eligible.

Funding

Victorian government grant and Peninsula Health; no conflicts declared.

Clinical Application

Consider supervised trained assistants to expand inpatient mobility rehabilitation, but confirm effectiveness before changing staffing standards broadly.