Breakthroughs Can’t Wait: At UMSON and at UMB, groundbreaking discoveries happen every day — transforming care, improving health, and shaping the future. Our researchers are tackling real-world challenges and making a lasting impact on lives everywhere. Dive into inspiring stories of innovation from across UMB’s seven schools, including the School of Nursing. See how we’re addressing today’s most pressing issues — fueled by the critical support of government funding that drives progress forward. Learn more about Dr. Burch's research.
Researcher:
Brittany Burch, PhD, RN, assistant professor
Areas of Expertise:
Burch researches ways to help older adults maintain their independence. Her work focuses on physical activity, physical function, and how thoughtfully designed technologies can support mobility and well-being during vulnerable periods, such as hospitalization. She is especially interested in interventions that are practical yet engaging.
The BIG Idea:
With each day an older adult spends in the hospital, they lose muscle simply from being in bed. Burch saw the consequences of this repeatedly in her clinical work. “As a home care nurse, I cared for patients who went to the hospital for an acute illness and returned profoundly weakened,” Burch says. “Some struggled to walk. Others could no longer manage at home at all and instead required nursing home placement.”
Before that, while providing nursing care in a hospital, Burch saw the other side of the problem: Nurses want patients out of bed and moving, but between medications, procedures, monitoring, documentation, and urgent clinical needs, there is often little time. The result is an unintended but deeply consequential cycle of immobility and decline.
“That tension is what drives my research,” Burch says. “I wanted to create an intervention that helps hospitalized older adults stay active, preserve their physical function, and feel engaged in their care, without adding yet another task to an already overburdened workforce.”
Burch is implementing an intervention called Preserving Ability through Virtual Exercise (PAVE). Through PAVE, older patients are taught how to use virtual reality (VR) headsets to engage in physical activity matched to their mobility level, including exercises they can do in bed or in a chair. The headset is at the bedside so that during downtime, when patients are often bored, isolated, and inactive, they can independently move to music they love while immersed in beautiful natural environments.
“We intentionally use joy and play as motivators,” Burch said. “Along with preserving physical function, we hope the immersive experience supports patients’ mental and emotional well-being during hospitalization.”
Why Does the Research Matter?
One of the strengths of nursing research is that the reason it matters is often intuitive. Nurses see problems as they are happening and look for direct, practical solutions that improve people’s day-to-day lives, Burch says. “My research grew out of that same instinct: recognizing a need and asking how we can do better,” she explains.
People are living longer than ever before, and many will experience multiple hospitalizations as they age. “We need to figure out how to maintain older adults’ functional health across these hospital stays,” she says.
Her research matters because functional decline during hospitalization is common, predictable, and largely preventable. “If we want hospitals to be places of healing, we must rethink how we support movement, autonomy, and dignity for older adults during their stay,” Burch says.
Who Does the Research Matter To?
This work matters first to older adults who want to return home, remain independent, and feel like active participants in their care. It matters to families who watch a loved one change dramatically after a hospital stay. It matters to nurses and clinicians who feel moral distress when they see preventable decline but lack the time or resources to intervene.
“Ultimately, this research matters to anyone who may one day be hospitalized, which, sooner or later, is almost all of us,” Burch says.
What Are the Clinical Applications of the Research?
Burch’s hope is that the PAVE intervention will help hospitalized older adults maintain their physical function, reinforcing the hospital’s role as an environment of healing rather than of functional decline.
PAVE is a quasi-experimental trial, with the first 60 participants receiving an education-only control and the next 60 participants receiving the PAVE intervention.
The overall objective of the PAVE study is to:
- determine the feasibility of the VR intervention among hospitalized older adults, compared to an education control group
- test the hypothesis that patients exposed to the VR intervention will demonstrate greater time spent in physical activity throughout their hospital stay and better maintain their physical function when compared to those exposed to the education control.
As VR technology becomes more affordable and available across the world, the study seeks to demonstrate how the technology can be leveraged to maintain the function of older adults. In doing so, the study complements the National Institute on Aging’s mission to develop interventions to maintain older adults’ physical function and prevent disability, Burch explains.
If PAVE is shown to be acceptable and effective, Burch envisions two key areas of impact. First, she would like to see PAVE scaled across hospitals as a low-burden approach to preserving physical function, even in settings with limited staffing resources. Secondly, she hopes this work can educate researchers and developers of virtual reality technologies, demonstrating that older adults can and do benefit from these tools and that applications should be intentionally designed to be accessible and engaging for this population.