Live Long Walk Strong (LLWS) Rehabilitation Program: What Features Improve Mobility Skills

Study Overview
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Brief Summary
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This study is being performed to evaluate the efficacy of the Live Long Walk Strong rehabilitation program in Veterans 50 years and older. This study will also examine the features of the program that contribute to improved gait speed.

Detailed Description
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Due to COVID-19, currently completed a virtual version of the LLWS intervention study. The investigators are currently recruiting for the original study design in-person. This study is a 4 year phase II randomized clinical trial study design. This study will provide important information about the mechanisms that contribute to meaningful improvement in mobility, the benefits of a novel mode of physical therapy care, and the duration of treatment effect.

Official Title
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The Live Long Walk Strong Rehabilitation Program: What Features Improve Mobility Skills?

Conditions
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Mobility Limitation

Intervention / Treatment
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* Other: Live Long Walk Strong rehabilitation program


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Veteran Aged 50 and older Community dwelling Ability to speak and understand English Usual gait speed 0.5 m/s- 1.0 m/s Activity modifications and access to telehealth rehabilitation Exclusion Criteria: Presence of a terminal disease A major medical problem, unstable chronic condition, or psychiatric disorder that interferes with safe and successful testing and training Myocardial infarction or major surgery in previous 3 months Planned major surgery Baseline short physical performance battery score less than 4 Use of a walker Modified mini mental status examination score less than or equal to 77 Presence of a significant disease specific impairment such as: peripheral neurologic impairment orthopedic impairment visual impairment

Ages Eligible for Study
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Minimum Age: 50 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

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
Interventional Model Description: Participants are assigned to 8 week Live Long Walk Strong rehabilitation or 8 week wait list control then the LLWS rehabilitation program.
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Live Long Walk Strong<br>8 week rehabilitation program | Other: Live Long Walk Strong rehabilitation program<br>* Live Long Walk Strong is a rehabilitation program that focuses on impairments known to contribute to mobility decline that are not considered standard of care in rehab and addresses behavioral change within the context of rehabilitation.<br>|
| Active Comparator: 8 week wait list control<br>8 week wait list then followed by 8 weeks of the Live Long Walk Strong rehabilitation program | Other: Live Long Walk Strong rehabilitation program<br>* Live Long Walk Strong is a rehabilitation program that focuses on impairments known to contribute to mobility decline that are not considered standard of care in rehab and addresses behavioral change within the context of rehabilitation.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Gait Speed | Gait speed change will be assessed within 2 weeks post intervention and then in 8 and 16 weeks of subsequent follow-up. Virtual only pilot assessing the feasibility of the LLWS program in a virtual format. | within 2 weeks, 8 weeks, 16 weeks follow up | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Lower Extremity Power | Lower extremity power measure will be assessed at 3 time points post intervention. Power will be assessed via a keiser machine (force) and stair climb test (seconds). | within 2 weeks, 8 weeks, 16 weeks follow up | 
| Trunk Muscle Endurance | Trunk muscle endurance will be measured at 3 time points post intervention. Trunk endurance will be assessed via saunders table through time (seconds) held in a fixed position. | within 2 weeks, 8 weeks, 16 weeks follow up | 
| Gait Variability | Gait variability will be measured at 3 time points post intervention. Gait variability will be assessed via zeno gait mat measurement of step length, step width and other measures of gait quality captured via the pkmas software within the zeno gait mat. | within 2 weeks, 8 weeks, 16 weeks follow up | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Rehabilitation, Aging, Mobility Skills