Restoring Skill in Walking

Study Overview
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Brief Summary
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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
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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).

Official Title
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Restoring Skill in Walking

Conditions
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Mobility Limitation

Intervention / Treatment
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* Behavioral: gait intervention


Participation Criteria
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Eligibility Criteria
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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%)

Ages Eligible for Study
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Minimum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Intervention/Treatment |
| --- |
|Behavioral: gait intervention|nan|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | 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 Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Physical activity, endurance in walking, falls efficacy, performance of usual activities of living, pre and post intervention (12 weeks) |  |  | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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gait impairment