WALK+

Abstract

PURPOSE: The purpose of this study was to determine, in older adults at risk for mobility disability, whether a walking program supplemented by tasks designed to challenge multiple systems (WALK+: balance, coordination, cognition, and lower extremity function) could improve physical function more than a traditional walking program (WALK). METHODS: 37 older adults (M+SD age=75.4+5.9 yrs) with compromised lower extremity function (Short Physical Performance Battery (SPPB)=8.9+1.7) were recruited for this study. Participants were randomized to treatment. Both interventions were 6 wks in length (1hr, 3x/wk), were tailored to the individual ability of each participant, and were progressive in intensity and duration. Measures of physical function included the SPPB, lateral mobility (LM), one leg balance (OLB), functional reach (FR), 400m-Walk (400m-W), and timed-up and go (TUG). Data were analyzed with an analysis of covariance on change scores with the pretest score used as the covariate. RESULTS: Table 1 shows adjusted change scores for the WALK and WALK+ interventions. The WALK+ group improved their SPPB score more than the WALK group following the treatment (F=4.12, p=0.05). Although changes in the other outcomes did not reach statistical significance, trends in LM, OLB, 400m-W, and TUG were consistent with the SPPB data.TableCONCLUSION: These data suggest that a complex physical activity intervention that challenges multiple systems may be more effective for improving physical function than a traditional walking program. The WALK+ intervention produced a clinically meaningful change in the SPPB (Perera et al., JAGS, 54, 743–9, 2006), a measure that has been associated with institutionalization and mortality in older adults.