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Trial registered on ANZCTR
Registration number
ACTRN12611000034932
Ethics application status
Approved
Date submitted
10/01/2011
Date registered
11/01/2011
Date last updated
18/01/2016
Type of registration
Prospectively registered
Titles & IDs
Public title
Promoting activity for frail aged in post-acute hospital settings: a randomised controlled trial of accelerometry
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Scientific title
In frail aged rehabilitation inpatients is provision of activity data from accelerometry monitoring to assist goal setting more effective than usual rehabilitation care in increasing activity levels?
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Secondary ID [1]
253374
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APP: 1007886 National Health and Medical Research Council
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Universal Trial Number (UTN)
UTN 1111-1118-9227
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Musculoskeletal De-conditioning
260916
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Mobility decline
260918
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Condition category
Condition code
Physical Medicine / Rehabilitation
259075
259075
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0
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Physiotherapy
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Musculoskeletal
259076
259076
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0
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Other muscular and skeletal disorders
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Participants will wear an accelerometer from the time of waking in the morning until going to bed in the evening ie during waking hours. The accelerometer will be removed for showering. At commencement, the treating physiotherapist will discuss with the patient their mobility goals, including provisional targets for daily walking time. These goals will be re-examined and modified, informed by the accelerometer data, to motivate the patient to improve activity levels and reach set targets. The targets will be reviewed weekly until discharge or 4 weeks, whichever is sooner. Feedback of the previous day’s walking time will be given to the patient and treating therapist and will be recorded in the patient’s records. Walking times over a week will be summarised in chart form and made available at the weekly case conference. All staff will be trained in the use of accelerometry data and be asked to encourage patients to meet their activity goals.
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Intervention code [1]
257816
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Treatment: Devices
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Intervention code [2]
257817
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Rehabilitation
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Comparator / control treatment
Usual rehabilitation care including the setting of mobility goals. Neither staff nor patients will receive data on monitored walking times to aid in the setting of walking time targets.
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Control group
Active
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Outcomes
Primary outcome [1]
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Daily walking times as assessed by accelerometry
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Assessment method [1]
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Timepoint [1]
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Repeated daily measures during the study period
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Secondary outcome [1]
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Lower extremity function as measured by the Short Physical Performance Battery
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Assessment method [1]
268785
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Timepoint [1]
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At study entry and exit
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Secondary outcome [2]
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Functional status as assessed using the interRAI Post-Acute Care instrument
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Assessment method [2]
268786
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Timepoint [2]
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At study entry and exit and 28 day phone follow-up post discharge
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Secondary outcome [3]
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Exercise self-efficacy as measured by the Short Self-Efficacy and Outcome Expectation for Exercise Scales
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Assessment method [3]
268787
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Timepoint [3]
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At study entry and exit
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Secondary outcome [4]
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Health-related quality of life as measured by EQ-5D
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Assessment method [4]
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Timepoint [4]
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At study entry and exit and 28 day phone follow-up post discharge
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Secondary outcome [5]
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Length of stay recorded on hospital discharge records
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Assessment method [5]
268836
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Timepoint [5]
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At discharge from rehabilitation
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Eligibility
Key inclusion criteria
Patients admitted to post-acute care rehabilitation who are (1) aged greater than or equal to 60 years; (2) able to ambulate independently or with supervision, or who have a rehabilitation goal to become ambulant within the context of the current admission; and (3) expected to have a length of stay of at least 2 weeks will be eligible to participate.
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Minimum age
60
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Exclusion criteria will be those (1) with lower limb amputation; (2) with delirium/agitated dementia; or (3) not expected to walk within 4 weeks of admission.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
At each site, within 3 days of admission to post acute care rehabilitation, eligible patients will be identified by a staff member from the rehabilitation team and the names will be given to the research member, who will obtain informed consent for participation. At point of entry into the study, and prior to random allocation to either the intervention or control group, consenting participants will be stratified by mobility status - either walking independently (with or without walking aids) or walking with supervision. A random number sequence will be generated for the order of group allocation within the two strata. Random group allocation will be centrally managed by a member of the research staff who is not involved in assessment of measures or intervention delivery.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
A random number sequence will be generated using computerised sequence generation for group allocation within the two strata. Random group allocation will be centrally managed by a member of the research staff who is not involved in assessment of measures or intervention delivery.
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people assessing the outcomes
The people analysing the results/data
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Intervention assignment
Parallel
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
1/07/2011
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Actual
31/10/2011
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Date of last participant enrolment
Anticipated
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Actual
12/09/2012
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
270
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Accrual to date
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Final
270
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Recruitment in Australia
Recruitment state(s)
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Recruitment hospital [1]
5064
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Princess Alexandra Hospital - Woolloongabba
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Recruitment hospital [2]
5065
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Hornsby Ku-ring-gai Hospital - Hornsby
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Recruitment hospital [3]
5066
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Repatriation Hospital - Daw Park
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Recruitment postcode(s) [1]
3531
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4102
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Recruitment postcode(s) [2]
3532
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2077
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Recruitment postcode(s) [3]
3533
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5041
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Funding & Sponsors
Funding source category [1]
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Government body
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Name [1]
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National Health and Medical Research Council
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Address [1]
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National Health and Medical Research Council
GPO Box 1421
Canberra ACT 2601
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Country [1]
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Australia
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Primary sponsor type
University
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Name
The University of Queensland
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Address
Research and Innovation Division, The University of Queensland, St Lucia, QLD 4072
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Country
Australia
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Secondary sponsor category [1]
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None
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Name [1]
257454
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Address [1]
257454
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Country [1]
257454
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
260276
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Metro South Human Research Ethics Committee
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Ethics committee address [1]
260276
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Princess Alexandra Hospital, Brisbane, Queensland, 4102, Australia
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Ethics committee country [1]
260276
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Australia
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Date submitted for ethics approval [1]
260276
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18/01/2011
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Approval date [1]
260276
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11/03/2011
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Ethics approval number [1]
260276
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HREC/11/QPAH/043
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Ethics committee name [2]
294187
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Northern Sydney Local Health District Human Research Ethics Committee
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Ethics committee address [2]
294187
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Level 2 Building 31, Royal North Shore Hospital, St Leonards, NSW 2065
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Ethics committee country [2]
294187
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Australia
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Date submitted for ethics approval [2]
294187
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03/02/2011
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Approval date [2]
294187
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03/03/2011
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Ethics approval number [2]
294187
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HREC/11/HAWKE/14
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Ethics committee name [3]
294188
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Southern Adelaide Clinical Human Research Ethics Committee
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Ethics committee address [3]
294188
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Flinders Medical Centre, Bedford Park, SA 5042, Australia
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Ethics committee country [3]
294188
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Australia
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Date submitted for ethics approval [3]
294188
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14/01/2011
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Approval date [3]
294188
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23/03/2011
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Ethics approval number [3]
294188
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SAC HREC 012.11
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Summary
Brief summary
BACKGROUND A goal in rehabilitation for older people is promotion of mobility to reverse functional decline and deconditioning. Recent developments in accelerometry for quantifying ambulatory activity can assist clinical practice in rehabilitation settings. AIM The study tests the hypothesis that use of accelerometry to provide accurate activity data to patients and clinicians, in the context of explicit goal setting, substantially increases patient walking activity. The study will also explore the effects of increased activity on patient outcomes and undertake a cost utility analysis. RESEARCH PLAN A randomised controlled trial will be conducted in Geriatric Rehabilitation Units at 3 sites (QLD, NSW, SA). Eligible patients are aged greater than or equal to 60 and able to ambulate. Based on pilot data, a sample size of 270 patients (135 per group) is required to demonstrate a mean significant differencein daily walking time of 33% between intervention and control groups.Accelerometers will be fitted to eligible subjects to monitor daily activity. Intervention subjects will be offered a formal activity-related rehabilitation goal, and receive daily feedback, sourced from the accelerometer, of their activity levels. Neither staff nor subjects in the control arm of the trial will receive data on walking times. The primary outcome measure will be walking times measured by accelerometry. Secondary outcome measures will include lower extremity function, quality of life, length of stay, post discharge hospital readmissions and level of care at one month follow-up. The time frame for the study is two years six months. SIGNIFICANCE If patient activity can be increased through the use of accelerometer data, it will revolutionise the management of activity in hospital. There will be enormous impetus to further develop accelerometer technology for clinical application so that activity prescription will be a routine component of a rehabilitation care plan.
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Trial website
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Trial related presentations / publications
Dakin LE, Gray LC, Peel NM, Salih SA, Cheung VH. Promoting walking amongst older patients in rehabilitation: are accelerometers the answer? J Nutr Health Aging 2010;14(10):863-5.
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Public notes
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Contacts
Principal investigator
Name
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Prof Leonard Gray
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Address
32069
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Centre for Research in Geriatric Medicine
The University of Queensland School of Medicine
Level 2 Building 33
Princess Alexandra Hospital
Woolloongabba QLD 4102
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Country
32069
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Australia
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Phone
32069
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+61 7 3176 5530
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Dr Nancye Peel
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Address
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Centre for Research in Geriatric Medicine, The University of Queensland School of Medicine, Level 2, Building 33, Princess Alexandra Hospital, Woolloongabba, QLD 4102
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Country
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Australia
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Phone
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+61 7 3176 7402
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Fax
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+61 7 3176 6945
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Email
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[email protected]
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Contact person for scientific queries
Name
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Professor Len Gray
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Address
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Centre for Research in Geriatric Medicine, The University of Queensland School of Medicine, Level 2, Building 33, Princess Alexandra Hospital, Woolloongabba, QLD 4102
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Country
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Australia
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Phone
6244
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+61 7 3176 5530
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Fax
6244
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+61 7 3176 6945
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Email
6244
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
Source
Title
Year of Publication
DOI
Embase
Promoting activity in geriatric rehabilitation: A randomized controlled trial of accelerometry.
2016
https://dx.doi.org/10.1371/journal.pone.0160906
N.B. These documents automatically identified may not have been verified by the study sponsor.
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