Gait, Unsteady
Conditions
Brief summary
Motor skill training therapy aims to improve the brain's control of walking and can improve clinic-based measures of walking in older adults. However, it is unknown whether the benefits of motor skill training extend to real world mobility measures. The investigators will test the effects of motor skill training on measures of community mobility of older adults and assess the mechanisms through improved motor control at the level of the brain. These results will inform intervention approaches to maintain community mobility of older adults and prevent disability and institutionalization.
Interventions
BEHAVIORALStrength training
weight lifting to increase muscle strength
BEHAVIORALEndurance training
treadmill walking to increase endurance
BEHAVIORALFlexibility training
stretches to improve flexibility
Intervention to encourage participants to be more physically active
stepping and walking patterns to improve timing and coordination of gait
Sponsors
National Institute on Aging (NIA)
University of Pittsburgh
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
BASIC_SCIENCE
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
65 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* 65 years of age and older * Ambulatory without an assistive device or the assistance of another person * Usual 4 meter gait speed \> 0.60 m/s and \< 1.2 m/s * Physician clearance to participate in a moderate intensity exercise program * Not meeting physical activity recommendations defined as reporting less than 150 minutes of moderate intensity activity per week in the past month.
Exclusion criteria
* persistent lower extremity pain that is present on most days of the week * back pain that is present on most days of the weeks and interferes with walking and - activities of daily living or back pain that increases with walking * refuse to walk on a treadmill * plans to move out of the area in the next 5 years * dyspnea at rest or during activities of daily living or use supplemental oxygen (CHF, COPD) * any acute illness or medical condition that is not stable according to the approving physician * resting systolic blood pressure ≥ 200 mm Hg or diastolic blood pressure ≥ 100 mm Hg or resting heart rate \> 100 or \< 40 beats per minute * diagnosed dementia or cognitive impairment defined as modified Mini-Mental State (3MS) examination \<79 * hospitalized in the past 6 months for acute illness or surgery, other than minor surgical procedures * severe visual impairment f- ixed or fused lower extremity joints such as hip, knee or ankle * lower extremity strength \<3/5 on manual muscle testing * lower extremity amputation * progressive movement disorder such as Multiple Sclerosis, Amyotrophic Lateral Sclerosis or Parkinson's disease
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in oxygenated hemoglobin at the prefrontal cortex from standing to walking | change from baseline to 12 weeks | Physiologic measure indicative of usage of the prefrontal cortex during a task recorded by optical imaging (near infrared spectroscopy). |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Gait speed | 12, 24, and 36 weeks | Walking speed (m/s) during usual pace |
| Gait variability | 12, 24, and 36 weeks | Fluctuations in gait characteristics from step to step during usual pace. Physiologic measure of temporal gait characteristics (standard deviation). |
Other
| Measure | Time frame | Description |
|---|---|---|
| Activity Space | 12, 24, and 36 weeks | Extent of travel beyond the home collected by GPS device based on a standard deviation ellipse of spatial measurement points. |
Countries
United States
Outcome results
None listed