Getting Older Adults OUT-of -Doors

NCT02339467 | Completed DMC

• 1 other identifier: H2014:391
• Study Type: interventional
• Target: 9
• Locations: 1 country
• Sites: 1

Brief Summary

Community walking is an issue that older adults with chronic conditions have described as important to participation in the community. Walking outside the home is a universally accessible form of physical activity that has multiple health benefits. Walking for 150 minutes per week can help reduce the risk of cardiovascular disease, hypertension, stroke, diabetes, osteoporosis, and depression, as well as falls. Practice walking across roads, slopes and curbs, while talking, and dealing with crowds and traffic, is safe and feasible and can improve confidence, balance and walking ability. Being physically active outdoors in nature appears to improve mental health more than being active indoors. Despite these health benefits, the majority of older Canadians do not walk outside on a regular basis. Barriers to walking outside include fear, physical disability due to chronic disease, the appropriateness of footwear and walking aids, and the physical environment, such as uneven pavement, weather and temperature. To date, the best strategy for getting people to walk outdoors regularly is unknown. The investigators propose to evaluate the effectiveness of a dynamic 1-day workshop, at which older adults who infrequently walk outdoors learn strategies to facilitate outdoor walking, such as appropriate use of footwear, ambulatory aids and equipment, goal setting, and practice skills related to increasing outdoor walking. The workshop will be compared to the workshop plus involvement in a walking group for 3 months. Outcomes include outdoor walking activity, total physical activity, walking ability, participation, and health-related quality of life. Each participant will have three evaluations: before the intervention and 3 and 6 months later. The investigators will interview select participants at 6 months to ask them about their opinions of what worked and didn't work. Increasing outdoor walking is expected to improve health and well-being, and help people live independently in the community for longer.

Conditions

Older Adults With Decreased Outdoor Walking Ability

Keywords

decreased outdoor walking ability; Older adult

Outcome Measures

Primary Outcomes (3)

• Change in Outdoor walking activity - CHAMPS questionnaire

  Self-report measure designed to evaluate interventions to increase physical activity among older persons. Will determine number of minutes at moderate to vigorous intensity of walking outdoors per week by focusing on 4 walking items.

  baseline, 3,6 months

• Change in Outdoor walking activity -GPS data

  Participants will wear the GlobalSat DG-200 Data Logger (www.gpscentral.ca/products/usglobalsat/dg200.html) clipped onto their waist band from the time they first get out of bed in the morning until they return to bed in the evening, removing it for showering, bathing, and swimming, for 14 days. Will determine The number of minutes spent walking per week outdoors.

  baseline, 3,6 months

• Change in Outdoor walking activity -Accelerometry

  The ActiGraph GT3X+ monitor (www.actigraphcorp.com/products/wgt3x-monitor/, ActiGraph, Pensacola, FL) will be worn by each participant, clipped onto their waist band over the right hip on the anterior axillary line along with the GPS. Time spent in sedentary, light, moderate and high intensity PA categories/day will be calculated.

  baseline, 3,6 months

Secondary Outcomes (5)

• Change in Aerobic capacity (Six minute walk test)

  baseline, 3,6 months

• Change in Walking competency (Berg Balance scale)

  baseline, 3,6 months

• Change in Mood (Geriatric depression scale)

  baseline, 3,6 months

• Change in Health Related Quality of life (The Rand-36)

  baseline, 3,6 months

• Change in Participation (CHAMPS)

  baseline, 3,6 months

Other Outcomes (1)

• Neighbourhood walkability (Neighbourhood Environment Walkability Scale (NEWS)

  baseline

Study Arms (2)

GO-OUT program

EXPERIMENTAL

An outdoor walking workshop with stations to learn various outdoor walking skills and information, followed by a supervised, group based outdoor walking program, twice a week for 60 minutes, for 3 months.

Other: GO-OUT program

Task-oriented outdoor walking workshop

ACTIVE COMPARATOR

An outdoor walking workshop with stations to learn various outdoor walking skills and information.

Other: Task-oriented outdoor walking workshop

Interventions

GO-OUT program OTHER

Participants attend the walking workshop followed by a 3-month outdoor walking group intervention, twice weekly for 60-minutes. Each session includes a 10-minute warm-up and cool down, and a planned walk in an outdoor community environment. Continuous walking exercise will gradually increase from 10 to 60 minutes, as well increase difficulty. Balance exercises will be included in the warmup and walk. There will be a variety of surfaces and environmental factors to challenge the participants, e.g., carrying objects, diverting the walker's attention, crossing at a light, walking up and down curbs, slopes, and level or uneven surfaces. Supervision will be on a 1:3 facilitator-to-participant ratio to allow for assistance and individualization of the intervention where necessary.

GO-OUT program

Task-oriented outdoor walking workshop OTHER

The 1-day workshop will be 5 hours with breaks. Participants will complete a series of stations learning information, strategies and skills related to safely walking outdoors. Stations include: pedometer use; walking pole use; footwear; footcare; fall prevention; balance exercises; proper use of walking aids; correct posture; self-management of exercise intensity; goal setting; and walking safely outdoors. Participants will receive a workbook with Canadian Physical Activity Guidelines, benefits of outdoor walking, information for each workshop station and a pedometer. Participants will use the workbook as an information resource and to record their community ambulation goals, planning routes, and walking time. All participants will be encouraged to walk outside with a partner, for safety.

Task-oriented outdoor walking workshop

Eligibility Criteria

• Age: 65 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Older Adult (65+)

You may qualify if:

• self-reported ability to walk continuously on a flat surface a distance of ≥1 block (\~50 metres or 164 feet) independently with or without a walking aid and without supervision
• outdoor walking limitation defined as self-reportedly accumulating ≤20 minutes of outdoor walking in a typical week
• mental competency indicated by a score of ≥18 on the telephone version of the Mini-mental State Exam

You may not qualify if:

• active walkers defined as accumulating ≥100 minutes of total (indoor and outdoor) walking per week
• have had ≥2 falls in the prior 12 months or present with an acute fall (based on American Geriatric Society fall guidelines)
• cardiac, respiratory, peripheral vascular or other health conditions that would prevent safe and full participation in the interventions
• currently receiving rehabilitation treatment such as physical or occupational therapy for goals related to walking
• postural hypotension determined by measuring lying and standing blood pressure
• severe limitations to visual acuity by a falls prevention screen
• resting heart rate under 45 or over 100.
• The PAR-Q+ (an evaluation of exercise readiness) will be completed by each participant. With participants' permission, their family physician will be asked to review the PAR-Q+ and confirm readiness to participate in exercise.

Sponsors & Collaborators

• University of Manitoba: lead
• University of Toronto: collaborator
• McGill University: collaborator
• University of Alberta: collaborator

Study Sites (1)

University of Manitoba College of Rehabilitation Sciences

Winnipeg, Manitoba, R3E 0W3, Canada

Location

Related Publications (1)

• Barclay R, Webber S, Ripat J, Grant T, Jones CA, Lix LM, Mayo N, van Ineveld C, Salbach NM. Safety and feasibility of an interactive workshop and facilitated outdoor walking group compared to a workshop alone in increasing outdoor walking activity among older adults: a pilot randomized controlled trial. Pilot Feasibility Stud. 2018 Nov 29;4:179. doi: 10.1186/s40814-018-0367-4. eCollection 2018.

  PMID: 30519481 DERIVED

Study Officials

• Ruth Barclay, PhD

  University of Manitoba

  PRINCIPAL INVESTIGATOR

• Nancy Salbach, PhD

  University of Toronto

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: January 7, 2015
• First Posted: January 15, 2015
• Study Start: February 1, 2015
• Primary Completion: November 1, 2015
• Study Completion: November 1, 2015
• Last Updated: May 17, 2017

Record last verified: 2016-05

Locations

CA (1)