Several tools are available to assess mobility in the ambulatory setting .
Relatively few studies support therapeutic exercise to improve mobility limitation .
Strong evidence supports resistance and balance exercises for improving mobility-limiting physical weakness and balance disorders .
Addressing functional deficits and environmental barriers with exercise and mobility devices can lead to improved function , safety , and quality of life for patients with mobility limitations
IMPORTANCE Mobility limitations are common in older adults , affecting the physical , psychological , and social aspects of an older adult 's life .
OBJECTIVE To identify mobility risk factors , screening tools , medical management , need for physical therapy  , and efficacy of exercise interventions for older primary care patients with limited mobility .
Effects of an Interactive Computer Game Exercise Regimen on Balance Impairment in Frail Community-Dwelling Older Adults: A Randomized Controlled Trial
Background Due to the many problems associated with reduced balance and mobility , providing an effective and engaging rehabilitation regimen is essential to progress recovery from impairments and to help prevent further degradation of motor skills . Objectives The purpose of this study was to examine the feasibility and benefits of physical therapy based on a task-oriented approach delivered via an engaging , interactive video game paradigm . The intervention focused on performing targeted dynamic tasks , which included reactive balance controls and environmental interaction . Design This study was a r and omized controlled trial . Setting The study was conducted in a geriatric day hospital . Participants Thirty community-dwelling and ambulatory older adults attending the day hospital for treatment of balance and mobility limitations participated in the study . Interventions Participants were r and omly assigned to either a control group or an experimental group . The control group received the typical rehabilitation program consisting of strengthening and balance exercises provided at the day hospital . The experimental group received a program of dynamic balance exercises coupled with video game play , using a center-of-pressure position signal as the computer mouse . The tasks were performed while st and ing on a fixed floor surface , with progression to a compliant sponge pad . Each group received 16 sessions , scheduled 2 per week , with each session lasting 45 minutes . Measurements Data for the following measures were obtained before and after treatment : Berg Balance Scale , Timed “ Up & Go ” Test , Activities-specific Balance Confidence Scale , modified Clinical Test of Sensory Interaction and Balance , and spatiotemporal gait variables assessed in an instrumented carpet system test . Results Findings demonstrated significant improvements in posttreatment balance performance scores for both groups , and change scores were significantly greater in the experimental group compared with the control group . No significant treatment effect was observed in either group for the Timed “ Up & Go ” Test or spatiotemporal gait variables . Limitations The sample size was small , and there were group differences at baseline in some performance measures . Conclusion Dynamic balance exercises on fixed and compliant sponge surfaces were feasibly coupled to interactive game-based exercise . This coupling , in turn , result ed in a greater improvement in dynamic st and ing balance control compared with the typical exercise program . However , there was no transfer of effect to gait function
Several tools are available to assess mobility in the ambulatory setting .
Relatively few studies support therapeutic exercise to improve mobility limitation .
Strong evidence supports resistance and balance exercises for improving mobility-limiting physical weakness and balance disorders .
Addressing functional deficits and environmental barriers with exercise and mobility devices can lead to improved function , safety , and quality of life for patients with mobility limitations
IMPORTANCE Mobility limitations are common in older adults , affecting the physical , psychological , and social aspects of an older adult 's life .
OBJECTIVE To identify mobility risk factors , screening tools , medical management , need for physical therapy  , and efficacy of exercise interventions for older primary care patients with limited mobility .