Preserving Ability Through Virtual Exercise (PAVE)

NCT ID: NCT07189286

Last Updated: 2025-12-18

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

NOT_YET_RECRUITING

Clinical Phase

NA

Total Enrollment

140 participants

Study Classification

INTERVENTIONAL

Study Start Date

2026-02-01

Study Completion Date

2030-01-01

Brief Summary

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Each day in the hospital leads to functional decline and loss of muscle mass, which older adults can find difficult or impossible to restore in the post-acute period. The overall objective of this proposed project is to explore the feasibility and preliminary efficacy of a virtual reality physical activity intervention at helping older adults engage in physical activity and maintain physical function and mental health during their hospital stay. As virtual reality technology becomes more affordable and ubiquitously available across the world, this study will demonstrate how this technology could be leveraged to maintain the function of older adults in the hospital.

Detailed Description

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Older adults (≥60 years) experience multi-level barriers to physical activity when hospitalized. Patient level barriers to physical activity when hospitalized include tethers (e.g., foley catheters, intravenous infusions), symptoms of their acute illness (e.g., pain, fatigue), low self-efficacy to perform physical activity, and a perception that they should remain on bedrest when hospitalized. Interpersonal barriers to physical activity, highlighted during this post pandemic environment, include staffing shortages and increased patient acuity, which can force nurses to prioritize other critical tasks over the physical activity of their patients. Environmental barriers to physical activity include bed alarms and a hospital climate that is hyper focused on the incorrect assumption that physical activity increases fall risk among hospitalized older adults.

This lack of physical activity in the hospital generates major personal and societal costs. Each day a patient spends in the hospital increases their risk of functional decline and loss of muscle mass, which older adults can find difficult or impossible to restore in the post-acute period. Hospital associated deconditioning increases the length of hospital stays, and increases the susceptibility of patients to delirium, falls, and re-admission. Such complications ultimately increase health care costs. Therefore, there is a significant unmet need to identify strategies to increase older patients' physical activity while minimizing staff burden.

The overall objective of this proposed project is to explore the feasibility and preliminary efficacy of a virtual reality physical activity intervention to engage older adults in physical activity and maintain physical function and mental health during their hospital stay. This quasi-experimental study has two aims.

Primary) Aim 1: Using the NIH Behavior Change consortium guidelines, the Acceptability/Appropriateness of Intervention Measure, the Simulator Sickness Questionnaire, and semi-structured individual interviews, determine the feasibility of a virtual reality intervention among hospitalized older adults.

Aim 2: Test the preliminary efficacy of the PAVE intervention on 1) time spent in physical activity during the hospital stay, 2) maintenance of physical function, and 3) maintenance of mental health, compared to the education only control group.

Hypothesis 2.1. Patients exposed to the PAVE intervention will demonstrate more time spent in physical activity (MotionWatch, Modified Physical Activity Vital Sign) during their hospital stay, when compared to those exposed to the education control, controlling for appropriate covariates.

Hypothesis 2.2. Patients exposed to the PAVE intervention will better maintain their physical function throughout their hospital stay (Barthel Index, UMove), when compared to those exposed to the education control, controlling for appropriate covariates.

Hypothesis 2.3. Patients exposed to the PAVE intervention will better maintain their mental health throughout their hospital stay (Hospital Anxiety and Depression Scale, Brief Reslience Scale), when compared to those exposed to the education control, controlling for appropriate covariates.

Conditions

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Feasibility Studies

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

SEQUENTIAL

This proposed study, Preserving Ability through Virtual Exercise (PAVE), will be a quasi-experimental trial among hospitalized older adults. We plan to recruit the 140 participants from one medical floor, with 70 in the intervention group and 70 in the control group. Recruitment will occur in blocks. First, during the pilot phase, we will recruit 10 intervention participants and then 10 control participants, followed by a temporary pause in recruitment to assess feasibility data and identify any needed protocol refinements. If any refinements are needed, we will submit an IRB modification. Next, we will resume recruitment of 30 intervention and then 30 control participants, followed by 30 intervention and then 30 control participants. Randomizing participants within unit is not feasible because control participants could be exposed to the intervention by observing or interacting with intervention participants (e.g., roommates performing the intervention.
Primary Study Purpose

PREVENTION

Blinding Strategy

NONE

Participants will not be blinded to the behavioral intervention they are receiving. However, we have designed this study with sequential (blocked) recruitment to minimize bias due to awareness of another group, such as a control group participant being roommates with a PAVE participant as they perform virtual reality physical activity.

Study Groups

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PAVE intervention

PAVE participants will be trained to use the virtual reality headset and perform virtual reality physical activity throughout their hospital stay.

Group Type EXPERIMENTAL

PAVE intervention

Intervention Type BEHAVIORAL

The commercial virtual reality app that will be used for the intervention, Supernatural, provides participants a trainer as they use their arms and legs (e.g., seated knee strikes) to smash targets to 500+ musical tracks. In this manner, this study employs fun as a motivator for exercise commencement and adherence while hospitalized. The research assistant will implement the intervention using the three-step approach including: (1) patient mobility screen, (2) orientation to the technology and intervention, and (3) ongoing assessment, adaptation, and motivation.

Education control

Education control will receive physical activity education using the NIH "Get Fit for Life" booklet.

Group Type ACTIVE_COMPARATOR

Education control

Intervention Type BEHAVIORAL

Education control participants will receive and physical activity education using the NIH "Get Fit for Life" booklet.

Interventions

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PAVE intervention

The commercial virtual reality app that will be used for the intervention, Supernatural, provides participants a trainer as they use their arms and legs (e.g., seated knee strikes) to smash targets to 500+ musical tracks. In this manner, this study employs fun as a motivator for exercise commencement and adherence while hospitalized. The research assistant will implement the intervention using the three-step approach including: (1) patient mobility screen, (2) orientation to the technology and intervention, and (3) ongoing assessment, adaptation, and motivation.

Intervention Type BEHAVIORAL

Education control

Education control participants will receive and physical activity education using the NIH "Get Fit for Life" booklet.

Intervention Type BEHAVIORAL

Other Intervention Names

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virtual reality physical activity

Eligibility Criteria

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Inclusion Criteria

1. in the last 48 hours, they were admitted to the medical floor that is the setting of the study,
2. are 60 years or older,
3. their bedside nurse approves their physical activity participation in this study

Exclusion Criteria

1. they are unable to pass the Evaluation to Sign Consent Measure,
2. they score 23 or lower on the Montreal Cognitive Assessment,
3. they have a diagnosis that could be worsened through virtual reality exercise (e.g., nausea, syncope, vertigo, upper extremity fractures/sprain/strain),
4. they have an attached medical device that decreases the safety of physical activity such as a nasogastric tube or continuous fluids running through a PICC line that cannot be paused, or
5. they are unable to follow commands or move their extremities against gravity during the UMove Mobility Assessment
6. they are unable to wear the virtual reality headset
7. they received the education control intervention or PAVE intervention during a prior admission
Minimum Eligible Age

60 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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National Institute on Aging (NIA)

NIH

Sponsor Role collaborator

The Claude D. Pepper Older Americans Independence Centers

OTHER

Sponsor Role collaborator

University of Maryland, Baltimore

OTHER

Sponsor Role lead

Responsible Party

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Brittany Burch

Assistant Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Brittany Burch, PhD, MSN, RN

Role: PRINCIPAL_INVESTIGATOR

University of Maryland Baltiomre

Locations

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UMMC Midtown Campus

Baltimore, Maryland, United States

Site Status

Countries

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United States

Central Contacts

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Brittany Burch, PhD, MSN, RN

Role: CONTACT

Phone: 4107063770

Email: [email protected]

Facility Contacts

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Gyasi Moscou-Jackson, PhD, MHS, RN

Role: primary

Other Identifiers

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1K01AG090761-01A1

Identifier Type: NIH

Identifier Source: secondary_id

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1K01AG090761-01A1

Identifier Type: NIH

Identifier Source: org_study_id

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