HealthySteps: Exercise for Older Adults With Mobility Limitation

Study Overview
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Brief Summary
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This study will compare three different exercise programs in older adults who report difficulty walking and will determine if the programs improve walking.

Official Title
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HealthySteps: A Pilot Randomized Controlled Trial of Exercise to Improve Walking Energetics, Fatigue, and Activity in Older Adults With Mobility Limitation

Conditions
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Mobility Limitation

Intervention / Treatment
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* Behavioral: Timing and Coordination
* Behavioral: Aerobic Walking
* Behavioral: Stretching and Relaxation


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Men and women who live in the lower mainland (greater Vancouver) area of British Columbia Aged 65 years or older Living independently in their own home Report mobility limitation, defined as any difficulty walking one-quarter mile (about 2-3 blocks) outside on level ground or climbing one flight of stairs (about 10 steps) without resting because of a health or physical problem Exclusion Criteria: Have a current medical condition for which exercise is contraindicated Have participated in an exercise intervention study in the past 6 months Do not have adequate cognitive function to provide informed consent and participate fully in the study Do not speak and understand English fluently

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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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
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Timing and Coordination<br> | Behavioral: Timing and Coordination<br>* This intervention is based on progressively difficult stepping and walking patterns that promote the timing and coordination of stepping within the gait cycle. Small-group 60-minute classes twice weekly for 12 weeks.<br>|
| Experimental: Aerobic Walking<br> | Behavioral: Aerobic Walking<br>* Outdoor walking with progressive increases in exercise intensity. Small-group 60-minute classes twice weekly for 12 weeks.<br>|
| Active Comparator: Stretching and Relaxation<br> | Behavioral: Stretching and Relaxation<br>* Full-body stretching, range-of-motion exercises, and relaxation techniques. No specific gait training. Small-group 60-minute classes twice weekly for 12 weeks.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| energy cost of walking | assessed by oxygen consumption during treadmill and overground walking | 12 weeks | 
| fatigue and fatigability | assessed by questionnaire, rated perceived exertion during walking, and decrements in walking performance over time. | 12 weeks | 
| daily activity | assessed by accelerometry and the Physical Activity Scale for the Elderly | 12 weeks | 
| life-space mobility | assessed by life-space mobility questionnaire | 12 weeks | 
| endurance | assessed by the long-distance corridor walk | 12 weeks | 
| physical function | assessed by standing balance, gait speed, and chair stands | 12 weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| energy cost of walking | assessed by oxygen consumption during treadmill and overground walking | 24 weeks | 
| fatigue and fatigability | assessed by questionnaire, rated perceived exertion during walking, and decrements in walking performance over time | 24 weeks | 
| daily activity | assessed by accelerometry and the Physical Activity Scale for the Elderly | 24 weeks | 
| life-space mobility | assessed by the life-space mobility questionnaire | 24 weeks | 
| endurance | assessed by the long-distance corridor walk | 24 weeks | 
| physical function | assessed by standing balance, gait speed, and chair stands | 24 weeks | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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energy cost of walking, energy metabolism, aged, older adult, exercise, gait, walking, aerobic, motor skill