Clinical Trial: Task Specific Timing and Coordination Exercise to Improve Mobility in Older Adults: Program to Improve Mobility in Aging

Study Status: Recruiting
Recruit Status: Recruiting
Study Type: Interventional

Official Title: Task Specific Timing and Coordination Exercise to Improve Mobility in Older Adults

Brief Summary: This randomized clinical trial targets 248 community-dwelling older adults with impaired mobility (i.e. walking slowly; gait speed < 1.20 m/s). The trial compares a 12 week "standard-plus" program of strength, endurance, flexibility plus task specific timing and coordination training to a standard 12 week strength, endurance and flexibility program. The primary outcome is gait speed at 12 weeks. Secondary and tertiary outcomes represent components of the intervention and measures of activity and participation. Delayed and sustained effects of the intervention are examined at 24 and 36 weeks.

Detailed Summary: Walking difficulty is common and costly in older adults. While traditional exercise has been shown to promote physical and mental health and may prevent walking difficulty, such exercise has focused on strength and endurance, and has overlooked a critical component of walking ability; the timing and coordination of movement. Aging and disease alter timing and coordination as reflected by slowed neuromotor performance, increased gait variability and reduced smoothness of movement. Task specific timing and coordination exercise that includes practice of smooth coordinated aspects of gait over multiple walking conditions has the potential to improve walking ability greater than a standard program. Our preliminary data suggest that interventions on timing and coordination of gait impact mobility greater than the standard strength and endurance program. The next key step and the objective of this proposal is to combine the two interventions to determine if potential gains in mobility, activity and participation obtained from a standard plus timing and coordination program, are larger than the gains obtained from the standard program alone. Therefore, the primary aim of the proposed project is to evaluate the impact of adding timing and coordination training to standard strength and endurance training on mobility. Secondary aims include examining 1) additional outcomes representing the components of the intervention and measures of activity and participation, 2) the delayed and sustained effects of the intervention, and 3) the effects of the intervention within various other subgroups of interest. This randomized clinical trial in 248 community-dwelling older adults who walk slowly (i.e. < 1.20 m/s) will compare a standard 12 week strength, endurance and flexibility program to a 12 week "standard-plus" program of strength, endurance, flexibility plus task specific timing and coordination training. The primary outcome is gait speed at 12 weeks. We will also ex
Sponsor: University of Pittsburgh

Current Primary Outcome: Gait speed [ Time Frame: 12 weeks ]

Usual walking speed over a short distance. A physiologic measure recorded in m/s.


Original Primary Outcome: Same as current

Current Secondary Outcome:

  • Smoothness of walking [ Time Frame: 12, 24, and 36 weeks ]
    acceleration signal of usual walking. physiologic measure of the acceleration of walking.
  • gait variability [ Time Frame: 12, 24, 36 weeks ]
    fluctuations in gait characteristics from step to step. physiologic measure of the spatial and temporal gait characteristics
  • Late Life Function and Disability Instrument - function subsacle [ Time Frame: 12, 24, and 36 weeks ]
    Self report measure of function
  • Late Life Function and Disability Instrument - disability subsacle [ Time Frame: 12, 24, and 36 weeks ]
    Self report measure of disability
  • Lower extremity strength [ Time Frame: 12, 24, and 36 weeks ]
    physiologic measure of leg strength
  • Lower extremity muscle power [ Time Frame: 12, 24, and 36 weeks ]
    physiologic measure of leg muscle power
  • Six minute walk test [ Time Frame: 12, 24, and 36 weeks ]
    physiologic measure of walking endurance
  • Chair sit and reach test [ Time Frame: 12, 24, and 36 weeks ]
    physiologic measure of flexibility
  • Physical activity [ Time Frame: 12, 24, and 36 weeks ]
    Physiologic measure of physical activity measured using an accelerometer.


Original Secondary Outcome: Same as current

Information By: University of Pittsburgh

Dates:
Date Received: January 21, 2016
Date Started: April 2016
Date Completion: July 2020
Last Updated: February 3, 2017
Last Verified: February 2017