Effect of a Researcher-Supervised Walking Program With Smartphone-Based Step Monitoring on Sleep Quality in Older Psychiatric Inpatients: A Randomized Controlled Trial

Background and aims: Sleep disorders are common among hospitalized older adults with psychiatric conditions and may adversely affect health. Structured walking is a promising nonpharmacological intervention, and smartphone-based step monitoring may support adherence. This study evaluated the effect of a researcher-supervised walking program supported by smartphone-based step monitoring on sleep quality in older adults admitted to a psychiatric hospital in Guilan Province, Iran.

Methods

In this randomized controlled trial, 62 hospitalized older adults were randomly assigned to the intervention or control groups. The intervention group received routine care plus a 4-week researcher-supervised walking program supported by smartphone-based step monitoring, consisting of 30-min outdoor walking sessions three times weekly. The control group received routine care alone. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI) at baseline and postintervention. The primary outcome was global PSQI score, assessed at baseline and postintervention. The prespecified primary analysis was ANCOVA; because its assumptions were not fully met, a post hoc change score analysis was conducted using Welch's t-test. Cohen's d with 95% confidence intervals was reported.