An interventional study of High Intensity Rehabilitation and Safe Transfers and Mobility Program in Aging, Functional Recovery and Skilled Nursing Facility, sponsored by University of Colorado, Denver. Not yet recruiting at 2 sites in United States. Open to participants aged 50 Years and older. Per ClinicalTrials.gov, last updated 2026-10-13.
Sponsored by University of Colorado, Denver · Not applicable, Interventional, and Treatment
This pilot study will evaluate the feasibility of a supplemental mobility intervention, the Safe Transfers And Mobility Program (STAMP). This program will be implemented in patients admitted to skilled nursing facilities (SNFs) following hospitalization. STAMP will be administered by a mobility aide who will support patients in increasing physical activity through walking and transfers outside of structured rehabilitation. Participants will either receive high-intensity rehabilitation (HIR) or usual care rehabilitation, combined with STAMP. The two main aims are: 1) determine the feasibility, acceptability, and safety of STAMP, and 2) evaluate the feasibility and variability of patient physical function outcome measures. The study will provide preliminary data on program delivery and safety to inform the design of a larger trial aimed at identifying the most effective strategies to optimize functional recovery in SNFs.
A substantial portion of older adults receiving care in skilled nursing facilities (SNFs) do not achieve successful outcomes, with nearly 40% unable to return home and up to 29% experiencing hospital readmission an outcome strongly associated with mortality. A major, modifiable contributor to these poor outcomes is reduced physical function. Although SNFs offer structured rehabilitation to address mobility impairments, its effectiveness is undermined by pervasive sedentary behavior. Up to 96% of patients receiving care in SNFs require assistance with mobility, and despite participating in daily rehabilitation, patients average less than 1,000 steps per day.
Our team conducted an NIH-funded pragmatic cluster randomized trial (R01, AG072693) evaluating high-intensity rehabilitation (HIR) to improve functional recovery. This trial provided a strong foundation and highlighted that high-intensity rehabilitation alone may be insufficient if patients remain inactive outside of scheduled sessions.
The purpose of this study is to determine the feasibility of an interdisciplinary, patient-centered mobility program (STAMP) to address common barriers in SNFs (e.g., staff shortages, safety concerns, limited training) and increase daily activity with support from a mobility aide. This aide will support patients in walking and functional transfers outside of formal therapy sessions, targeting 45 minutes of additional physical activity to complement structured rehabilitation. This study will explore whether STAMP alone or in combination with HIR offers a scalable strategy to improve function. The study will evaluate STAMP implemented in two settings: one with HIR + STAMP and one with usual care + STAMP. Investigators will determine feasibility, acceptability, and safety of STAMP through a convergent parallel mixed methods approach. Secondarily, investigators will evaluate the feasibility and variability of patient physical function outcome measures to inform outcome selection for future trials.
University of Colorado, Denver is the lead sponsor of 1,538 studies on the registry; 319 are open to participants now.
Of its 146 completed or terminated interventional studies of FDA-regulated products, 92 (63%) have results posted.
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Exclusion Criteria:
Other: Usual Care
Other: High Intensity Rehabilitation
Other: Safe Transfers and Mobility Program · Other: Usual Care
Other: High Intensity Rehabilitation · Other: Safe Transfers and Mobility Program
An 8RM is the dose necessary for most effective strength gains in community-dwelling older adults, and is equivalent to 80% of a one repetition max, which is the maximal load needed to voluntarily complete one repetition of a given exercise with proper form. Activities will include strength training, transfer practice, balance training, advanced ADLs. Clinicians will tailor the intervention for each activity to target overload using 8-repetition maximum for resistance training. Other interventions will be performed to muscle failure or inability to complete the final repetition. Failure is the inability to complete a repetition through the full, available range of motion without significant compensation. Further, high-intensity dosing requires continuous, volitional effort from the patient; therefore, incorporation of motivational interviewing strategies across sessions will maximize patient effort and self-efficacy.
The Safe Transfers and Mobility Program (STAMP) embeds a mobility aide into daily care. STAMP is a patient-centered, scalable approach to extend the benefits of rehabilitation sessions by increasing mobility throughout the day and reinforcing activity between therapy sessions. Core components are: (1) targeting 45 minutes of additional daily physical activity through support with walking and functional mobility tasks; (2) establishing individualized mobility goals collaboratively set by the therapist and patient, based on functional level; (3) delivering progressive activities with walking distances increased by \~30% weekly, adjusted for patient tolerance; and (4) interdisciplinary coordination to incorporate STAMP sessions into routine care with minimal disruption to clinical workflow. Prior work suggests that 45 minutes of STAMP can at least double daily step counts, and increasing walking distance by 30% per week is feasible even for individuals with low baseline function.
Usual Care SNFs will continue with routine collection and documentation of physical performance outcomes (gait speed, SPPB, Modified Barthel ADL Index) as standard practice. Importantly, the Usual Care SNF including the facility, rehabilitation clinicians, and patients will not have access to i-STRONGER materials.
Usual Gait Speed
Gait speed will be measured in meters/second using the time it takes to walk a 4-meter path at usual speed using a stopwatch. Completion rates will be collected. Within site pre- to post- STAMP changes will be assessed. Higher gait speed indicates better outcome.
Time frame: Admission into rehabilitation and discharge from rehabilitation, which would be an approximate average of 14 days
Feasibility of Intervention Measure (FIM)
Feasibility of Intervention (FIM) will be collected from SNF Providers to assess feasibility. The FIM is a 4-item survey rated on a 5-point Likert scale (1=completely disagree to 5=completely agree), with higher average scores indicating greater feasibility.
Time frame: At end of STAMP phase, approximately 8 months
STAMP Session Adherence Rate
Of all enrolled patients, percent completing ≥ 80% of sessions attempted by mobility aide
Time frame: Beginning of STAMP phase to end of STAMP phase, approximately 8 months
Modified 30 Second Sit to Stand
The Modified 30 second sit to stand test (m30STS) counts the number of stands from a chair completed in 30 seconds, which allows for upper extremity use on the armrests of a chair. The score is the total number of stands completed in 30 seconds; more than halfway up at the end of 30 seconds counts as a stand. Completion rates will be collected. Within site pre- to post- STAMP changes will be assessed. Higher scores indicate better outcomes.
Time frame: Admission into rehabilitation and discharge from rehabilitation, which would be an approximate average of 14 days
Number of Rehospitalizations
Number of re-hospitalizations during SNF stay.
Time frame: Up to 8 months of Pre-STAMP phase and 8 months of STAMP phase
STAMP Intervention Fidelity
Percent of mobility aides achieving an average of ≥80% fidelity across study assessments. A formally trained site champion or research team member will measure STAMP fidelity on at least 2 patients per mobility aide each quarter.
Time frame: Beginning of STAMP phase to end of STAMP phase, approximately 8 months
Theoretical Framework of Acceptability (TFA)
Theoretical Framework of Acceptability (TFA) will be collected from SNF Providers to assess acceptability of the STAMP intervention. The TFA is a survey, which includes 8 items rated 1-5 on a Likert scale and summed (higher scores indicate greater acceptability).
Time frame: At month 8 of STAMP phase
Pittsburgh Rehabilitation Participation Scale (PRPS)
Patient acceptability of the STAMP intervention will be assessed by mobility aides using the PRPS. The PRPS is a validated, single question, 6-point Likert-scale, rated by the mobility aide, that measures effort and participation. Higher score indicates more acceptability.
Time frame: Every patient encounter during STAMP phase
Change in Step Count
Change in daily step count from admission to discharge.
Time frame: Admission into rehabilitation and discharge from rehabilitation, which would be an approximate average of 14 days
Proportion of Patients with Increased Step Count
Of all enrolled patients, proportion achieving ≥20% increase in daily step count from admission to discharge.
Time frame: Admission into rehabilitation and discharge from rehabilitation, which would be an approximate average of 14 days
Change in Short Physical Performance Battery (SPPB)
The SPPB is comprised of 3 tasks: a hierarchical standing balance test (side-by-side, semi-tandem, and tandem), a 4-meter usual gait speed, and a 5-time sit-to-stand from a standardized chair. Each subtask is scored (based on time) from 0-4 points and then summarized into a total score of 0-12 points, where 12 points represents the highest performance. Completion rates and within site pre- to post-STAMP differences will be assessed.
Time frame: Admission into rehabilitation and discharge from rehabilitation, which would be an approximate average of 14 days
Change in Modified Barthel ADL Index (MBI)
The MBI assesses the ability to perform basic Activities of Daily Living (ADL) tasks. Total score range is 0-100. Total score is commuted by summing dependence across 10 ADL tasks: chair/bed transfers, ambulation, stair climbing, toilet transfers, bowel control, bladder control, bathing, dressing, personal hygiene (grooming), and feeding. Higher scores indicate increased independence. Completion rates and within site pre- to post-STAMP differences will be assessed.
Time frame: Admission into rehabilitation and discharge from rehabilitation, which would be an approximate average of 14 days
Plan to share: Yes — The study team guarantees that any and all data collected as part of this project will be released in accordance with standard data sharing policies and procedures to validate research findings if requested. Data will be made available in a timely manner to the broader scientific community, and will be complete, and as accurate as possible. All data released will be de-identified, with no information that could be linked to any study subjects, or participating study practices to ensure the confidentiality of all subjects and practices. If necessary, a data use agreement will be established.
Supporting information: Study protocol, Statistical analysis plan, Informed consent form
Time frame: The data will be available starting 1 year after primary study publication and ending 2 1/2 years after publication.
Access criteria: Data will be made available upon reasonable written request to the study team. The PI, Dr. Jennifer Stevens-Lapsley will review requests.
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From the registry record's own update history. This site started tracking changes on Sep 25, 2026; for anything earlier, see the record history on ClinicalTrials.gov ↗
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