Mobility Limitation
Conditions
Keywords
gait impairment
Brief summary
The purpose of the study is to examine the effect of an intervention to improve walking based on motor learning (skill-based) compared to the usual intervention (strength, flexibility and balance-based) on clinical, psychological and laboratory measures of walking and balance of older adults with mobility disability (walking problems).
Detailed description
While therapeutic exercise to improve mobility and balance appears to improve physical performance and may reduce falls, less is known about the responsiveness to specific interventions or the relation between response to intervention and the underlying problems or impairments. Therapeutic approaches for improving mobility and reducing fall risk are heterogeneous, but do not consistently focus on problem solving as a method of enhancing motor control or skill, an approach that has been found to be important for motor learning in animal models. This two-year pilot study will allows us to compare the clinical, psychological and laboratory outcomes after a motor-learning based and an impairment-targeted exercise intervention to improve walking in older adults. All subjects will participate in pre and post intervention testing and a 12 week exercise intervention for gait involving either a motor learning (skill enhancement) or impairment-targeted (lower extremity strengthening, flexibility and gait cues).
Interventions
BEHAVIORALgait intervention
Sponsors
National Institute on Aging (NIA)
University of Pittsburgh
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE
Eligibility
Sex/Gender
ALL
Age
65 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* 65 years of age and older * Ambulatory (with or without a straight cane, and without the assistance of another person) * Have written approval/clearance of their physician to participate in low to moderate intensity, supervised exercise as is characteristic of the interventions for improving gait. * Difficulty with walking or balance as indicated by the following two criteria during baseline testing: * mild to moderate slowing of walking speed (walking speed ≥ .6m/s and ≤ 1.0m/s) and, * gait variability (step length coefficient of variability, CV \> 4.5%, or step width CV \< 7% or \> 30%)
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Change in gait variability, energy cost of walking, perception of effort in walking, and adaptability of gait to changing environmental conditions, pre and post intervention (12 weeks) | — |
Secondary
| Measure | Time frame |
|---|---|
| Physical activity, endurance in walking, falls efficacy, performance of usual activities of living, pre and post intervention (12 weeks) | — |
Countries
United States
Outcome results
None listed