Early Walking and Mobilization during Hospitalization of Patients with Chronic Disease: A Systematic Review and Meta-Analysis of Experimental Studies

Purpose: To determine the impact of mobilization or walking on the recovery of functional capacity and other events in hospitalized adults with chronic causes.

Methods: Systematic review and meta- analysis. Data Sources included were MEDLINE, CINAHL online, HealthStar, EMBASE, Registered Clinical Trials in the Cochrane Library, LILACS, and manual review, all reviewed between years 2000-2012. Target studies included randomized controlled trials in any language comparing older adults hospitalized for chronic disease randomized to walking or to a control / standard intervention group during hospitalization. Two reviewers independently assessed study eligibility and quality and performed data extraction. We calculate standardized mean differences (SMD) or reported as Mantel-Haenszel odds ratio (OR) with confidence intervals of 95% (CI) using the random effects model (random effect). Heterogeneity was assessed (I2 analysis). The outcomes were improved functional capacity (measured by multiple scales), long stay, falls, and pulmonary thromboembolism.

Results: Out of 169 potentially relevant studies, 14 studies met our inclusion criteria. Conducting mobilization or progressive walking were associated with improvement in functional capacity in three studies using the scale Six Minute Walk, (142 patients, DMS 55.2 meters 95% CI 20.4, and 90.1, I ² = 66 %). Also there was a reduction in hospital length of stay for patients in the experimental group compared with a control group, in three studies (484 patients, DMS 3.27 95% CI -5.28,-1.26 days, I ² = 52 %) heterogeneity was observed.

Conclusion: Our meta-analysis showed an improvement in patients who were exposed to mobilization /walked during hospitalization and a reduction in hospital stay.