JMIR Publications

ABSTRACT

While sepsis, an exaggerated response to infection, can affect people of all ages, it is more prevalent in middle-aged and older adults. Older adults suffer worse short-term and long-term outcomes than younger patients. Older sepsis survivors are commonly discharged to long-term acute care facilities, where they often die within one year. Those who return home from the hospital lose the momentum of physical function improvement after early in-hospital rehabilitation, and often face exacerbation of comorbidities and decline in physical function. Additionally, patients who are discharged to home often live at distant locations and are not able to commute to rehabilitation centers due to their poor health status. Therefore, remotely delivered exercise interventions tailored to this population hold promise to improve physical function safely and effectively after sepsis. However, this model has yet to be tested in this population. The proposed intervention will be delivered through a digital health platform that is comprised of a patient-facing mobile application and consists of a 12-week physical activity program specifically designed for middle-aged and older sepsis survivors with poor health status who may face challenges in participating in traditional out-patient or community-based exercise interventions. This study will enroll 40 sepsis survivors aged 55 and older who will be randomized to either a remotely delivered exercise intervention or control groups (electronic health diary). Both groups will use a tablet containing the Health in MotionTM app (Blue Marble Health Platform BMHP, Altadena CA). The intervention group will receive a clinician-designed personalized avatar-guided home exercise program and reminders while the control group will self-report daily activities using the in-app health diary feature. This pilot study aims to assess the safety, feasibility, and ease of recruitment and retention participants for a remotely delivered physical activity intervention for improving physical function in middle-aged and older sepsis survivors. This study will provide important information for planning a future randomized clinical trial to test the efficacy of a remotely delivered exercise intervention in this high-risk population.