The Live Long Walk Strong Rehabilitation Program Study: Design and Methods

Abstract

ObjectiveTo identify attributes targeted by rehabilitative treatment within which improvements lead to short- and long-term changes in mobility. Maintaining independence in mobility is important to many older adults and is associated with critical outcomes such as aging in place, morbidity, and mortality. DesignThe Live Long Walk Strong rehabilitation study is a phase 2 single-blind, randomized controlled trial. SettingVeterans Affairs Boston Healthcare System, outpatient physical therapy. Participants198 community-dwelling middle- and older-aged veterans (aged 50 years and older) will be recruited from primary care practices (N=198). InterventionsComparing a moderate-vigorous intensity physical therapy program of 10 sessions with a waitlist control group. Main Outcome MeasureThe primary outcome measure is gait speed. Secondary outcomes include leg strength and power, trunk muscle endurance, gait smoothness, and exercise self-efficacy. ResultsOutcomes will be assessed within 2 weeks of intervention completion, at 8 weeks postintervention, and at 16 weeks postintervention. Two-sample t tests will compare mean change in gait speed and target attributes (leg power, trunk muscle endurance, gait smoothness, and exercise self-efficacy) between treatment and control groups. Paired t tests will examine within-person change at subsequent follow-up visits. Multivariable regression analyses will evaluate relationships between dependent and independent variables and potential mediation adjusting for relevant covariates. ConclusionsResults of this study are expected to advance and refine the design of Live Long Walk Strong rehabilitative care and demonstrate its proof of concept and efficacy.