Flexibility, Gait
Conditions
Keywords
hip, gait, walking, falls, stretching, Flexibility, Aged
Brief summary
Based on their preliminary quantitative gait findings suggesting that limited passive hip extension range is a key functionally limiting impairment affecting gait, the investigators propose a supervised, specific stretching exercise with the aim to improve both peak hip extension and overall gait performance. While one goal is to demonstrate that reduced peak passive hip extension is a key, functionally significant, but reversible, impairment another is to improve our understanding of the relationship between impairment, functional limitation and gait ability.
Detailed description
1. Test the hypothesis that both passive and dynamic hip extension during comfortable and fast walking speeds are reduced in the elderly groups compared to passive and dynamic peak hip extension in healthy young adults. 2. Test the hypothesis, separately for each elderly group, controlling for co-factors, that there is greater change in step length in the treatment group compared to the control group, after controlling for co-variates. We also expect greater changes in dynamic hip peak extension, a reduction in anterior pelvic tilt, improvement in age-related reductions in peak ankle plantar flexion and ankle power generation, and in dynamic CoM-CoP moment arm during both comfortable and fast walking, and an increase in comfortable walking speed. 3. Test the hypothesis separately for the frail elderly group who cannot independently perform IADL only, controlling for co-factors, that there is a greater change in secondary, non quantitative gait-parameters of the Timed Get Up and Go Test, Activities of Daily Living, Instrumental ADL function, fear of falling and number of falls during 6 months following intervention. 4. Test the hypothesis that the created forward dynamic model can accurately predict in individual subjects, the actual effect of an increase in passive peak hip extension on dynamic peak hip extension, anterior pelvic tilt, peak ankle plantar flexion and step length.
Interventions
OTHERHip Stretch
Hip flexor stretch daily for 3 min x 10 weeks
OTHERShoulder Stretch
Shoulder Adduction stretch - 3 minutes, daily, for 10 weeks
Sponsors
National Institutes of Health (NIH)
University of Virginia
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 85 Years
Healthy volunteers
Yes
Inclusion criteria
Healthy Elderly Adult Subjects: 1. 100 subjects aged 65 years and older will be recruited from the Charlottesville area. 2. Participants will be asked to fill out a health questionnaire identical to that used for all preliminary studies. This questionnaire verifies that the participants meet the inclusion criteria for the proposed research project. 3. After this initial health questionnaire screening, each participant will undergo a face-to-face history and physical examination screening. Frail Elderly Subjects: 1. 100 subjects aged 65 years and older who meet the criteria of not being able to function independently, which is considered to be frail, living within the greater Charlottesville area will be recruited for participation in the study.
Exclusion criteria
Healthy Elderly: 1. acute medical illness, 2. diagnosis or symptoms of unstable angina or congestive heart failure, 3. pulmonary diagnosis or symptoms of emphysema, chronic obstructive disease or asthma and shortness of breath as a result of pulmonary diagnosis brought about by walking on a flat surface, 4. advanced cancer, 5. neurologic diagnosis including Parkinson's Disease, stroke, brain injury, cerebellar disease, myelopathy, myopathy, peripheral neuropathy, or active radiculopathy, 6. major orthopedic diagnosis in the lower back, pelvis, or lower extremities, including hip or other fracture since the age of 50, fused joint, joint replacement, or amputation, 7. severe osteoarthritis or rheumatoid arthritis or active joint or musculoskeletal pain in the back or lower extremities occurring at rest or with walking, 8. severe osteoporosis with a history of a fragility fracture occurring in the past 12 months, and 9. regular use of an assistive device for walking.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Hip Extension | 10 weeks |
Secondary
| Measure | Time frame |
|---|---|
| Hip Flexibility | 10 weeks |
Countries
United States
Outcome results
None listed