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

NCT02663778 | Completed DMC

• 1 other identifier: PRO14080080
• Study Type: interventional
• Target: 353
• Locations: 1 country
• Sites: 1

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.

Conditions

Gait, Unsteady

Outcome Measures

Primary Outcomes (1)

• Gait speed

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

  12 weeks

Secondary Outcomes (9)

• Smoothness of walking

  12, 24, and 36 weeks

• gait variability

  12, 24, 36 weeks

• Late Life Function and Disability Instrument - function subscale

  12, 24, and 36 weeks

• Late Life Function and Disability Instrument - disability subscale

  12, 24, and 36 weeks

• Lower extremity strength

  12, 24, and 36 weeks

Other Outcomes (3)

• Falls

  16, 20, 24, 28, 32, 36, 40, 44, 48, 52, 56, and 60 weeks

• Emergency room visits

  16, 20, 24, 28, 32, 36, 40, 44, 48, 52, 56, and 60 weeks

• Hospital admission

  16, 20, 24, 28, 32, 36, 40, 44, 48, 52, 56, and 60 weeks

Study Arms (2)

Standard

ACTIVE COMPARATOR

The standard arm consists of strength, endurance and flexibility exercises 2 times per week for 12 weeks. Will also receive a physical activity behavioral intervention.

Behavioral: Strength training; Behavioral: Endurance training; Behavioral: Flexibility training; Behavioral: Physical activity behavioral intervention

Standard-plus

EXPERIMENTAL

The standard-plus arm consists of strength, endurance and flexibility exercises plus task specific timing and coordination exercises to improve gait 2 times per week for 12 weeks. Will also receive a physical activity behavioral intervention.

Behavioral: Strength training; Behavioral: Endurance training; Behavioral: Flexibility training; Behavioral: Task Specific timing and coordination training; Behavioral: Physical activity behavioral intervention

Interventions

Strength training BEHAVIORAL

weight lifting to increase muscle strength

Standard; Standard-plus

Endurance training BEHAVIORAL

treadmill walking to increase endurance

Standard; Standard-plus

Flexibility training BEHAVIORAL

stretches to improve flexibility

Standard; Standard-plus

Task Specific timing and coordination training BEHAVIORAL

stepping and walking patterns to improve timing and coordination of gait

Standard-plus

Physical activity behavioral intervention BEHAVIORAL

Intervention to encourage participants to be more physically active

Standard; Standard-plus

Eligibility Criteria

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

You may qualify if:

• years of age and older
• Ambulatory without an assistive device or the assistance of another person
• Usual 4 meter gait speed \> 0.60 m/s and \< 1.2 m/s
• Physician clearance to participate in a moderate intensity exercise program
• Not meeting physical activity recommendations defined as reporting less than 150 minutes of moderate intensity activity per week in the past month.7

You may not qualify if:

• persistent lower extremity pain that is present on most days of the week
• back pain that is present on most days of the weeks and interferes with walking and activities of daily living or back pain that increases with walking
• refuse to walk on a treadmill
• plans to move out of the area in the next 5 years
• dyspnea at rest or during activities of daily living or use supplemental oxygen (CHF, COPD)
• any acute illness or medical condition that is not stable according to the approving physician
• resting systolic blood pressure ≥ 200 mm Hg or diastolic blood pressure ≥ 100 mm Hg or resting heart rate \> 100 or \< 40 beats per minute
• diagnosed dementia or cognitive impairment defined as modified Mini-Mental State (3MS) examination \<79
• hospitalized in the past 6 months for acute illness or surgery, other than minor surgical procedures
• severe visual impairment
• fixed or fused lower extremity joints such as hip, knee or ankle
• lower extremity strength \<3/5 on manual muscle testing
• lower extremity amputation
• progressive movement disorder such as Multiple Sclerosis, Amyotrophic Lateral Sclerosis or Parkinson's disease

Sponsors & Collaborators

• University of Pittsburgh: lead

Study Sites (1)

University of Pittsburgh

Pittsburgh, Pennsylvania, 15219, United States

Location

Related Publications (2)

• Dunlap PM, Crane BM, Perera S, Moored KD, Carlson MC, Brach JS, Klatt BN, Rosso AL. Effects of a Physical Therapist Intervention on GPS Indicators of Community Mobility in Older Adults: A Secondary Analysis of a Randomized Controlled Trial. Phys Ther. 2023 Aug 1;103(8):pzad071. doi: 10.1093/ptj/pzad071.

  PMID: 37364044 DERIVED

• Brach JS, Perera S, Shuman V, Gil AB, Kriska A, Nadkarni NK, Rockette-Wagner B, Cham R, VanSwearingen JM. Effect of Timing and Coordination Training on Mobility and Physical Activity Among Community-Dwelling Older Adults: A Randomized Clinical Trial. JAMA Netw Open. 2022 May 2;5(5):e2212921. doi: 10.1001/jamanetworkopen.2022.12921.

  PMID: 35604689 DERIVED

MeSH Terms

Conditions

Gait Disorders, Neurologic

Interventions

Resistance Training; Endurance Training

Condition Hierarchy (Ancestors)

Neurologic Manifestations; Nervous System Diseases; Signs and Symptoms; Pathological Conditions, Signs and Symptoms

Intervention Hierarchy (Ancestors)

Exercise Therapy; Rehabilitation; Aftercare; Continuity of Patient Care; Patient Care; Therapeutics; Physical Therapy Modalities; Physical Conditioning, Human; Exercise; Motor Activity; Movement; Musculoskeletal Physiological Phenomena; Musculoskeletal and Neural Physiological Phenomena

Study Officials

• Jennifer S Brach, PhD, PT

  University of Pittsburgh

  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: PRINCIPAL INVESTIGATOR
• PI Title: PhD

Study Record Dates

• First Submitted: January 21, 2016
• First Posted: January 26, 2016
• Study Start: April 1, 2016
• Primary Completion: January 1, 2020
• Study Completion: February 1, 2021
• Last Updated: September 20, 2021

Record last verified: 2021-09

Locations

US (1)