Low hospital mobility-resurgence of an old epidemic within a new pandemic and future solutions.

Abstract

Low mobility during hospitalization poses risks of functional decline and other poor outcomes for older adults. Given the pervasiveness of this problem, low mobility during hospitalization was first described as ‘dangerous’ in 1947 and later described as an epidemic. Hospitals have made considerable progress over the last half-century and the last two decades in particular, however, the COVID-19 pandemic presents serious new challenges that threaten to undermine recent efforts and progress towards a culture of mobility. In this special article, we address the question of how to confront an epidemic of immobility within a pandemic. We identify 4 specific problems for creating and advancing a culture of mobility posed by COVID-19: social distancing and policies restricting patient movement, personnel constraints, PPE shortages, and increased patient hesitancy to ambulate. We also propose 4 specific solutions to address these problems. These approaches will help support a culture of healthy mobility during and after hospitalization and help patients to keep moving during the pandemic and beyond.