By Andy Skean
Previous research has demonstrated a correlation between bedrest and disability, especially among patients aged 65 and older. More recent studies of wearable mobility sensors, however, have shown that even a limited number of steps taken by patients during hospitalization can make the difference between functional decline and preserved independence.
“We have a culture of bedrest in the hospital, yet we know that it is a major factor in patients’ ability to recover from an acute illness and return to their previous level of function once they leave the hospital,” says S. Ryan Greysen, MD, MHS, MA, FHM.
To help address the issue, Dr. Greysen and colleagues developed a mobility plan consisting of five levels, from 0 (bed-bound) to fully mobile (level 4). “Our experience is that many patients have lower mobility levels when they are first hospitalized, but often are able to progress one or two levels by the time they are discharged, especially if given specific goals like those in our mobility plan,” Dr. Greysen says. “We place laminated cards detailing these levels in each room for patients to see. The nurse conducts a simple mobility assessment each day and tells the patient what level they are and the corresponding mobility goal. This helps them progress through the levels and prepares them for their transition home.”
Dr. Greysen believes a thoughtful plan to address functional status and mobility during and after hospitalization could help reduce the number of discharges to skilled nursing facilities, enhance patient engagement and experience, and perhaps inﬂuence post-discharge outcomes.
Ryan Greysen, MD, MHS, MA, FHM, has indicated to Physician’s Weekly that he has no financial interests to disclose.
Greysen S, Patel M. Bedrest Is Toxic—Why Mobility Matters in the Hospital. Ann Intern Med. 2018;169(2):HO2-HO3. Available at