Physical Activity In Older Adults Research Articles

The continuous growth of the older adult population demands an urgent need to provide innovative ways to stimulate physical activity and promote functional health. This study presents FitFest, a custom-made virtual reality (VR) designed to deliver a complete physical activity (PA) session for older adults. A pilot study involving seven older adults (67.0 ± 3.8 years) was conducted, comprising 18 user testing sessions of two VR exergames: Wine Fest and Flower Fest. PA intensity and heart rate (HR) were measured. The rate of perceived exertion (RPE) and the participants’ rating of the system’s usability were also registered. Overall, sessions involved mostly sedentary behavior (56.5 ± 20.4%) and light PA (42.1 ± 19.3%), with an average of 436.7 steps and 92.1 bpm. Wine Fest elicited less sedentary behavior (53.6 ± 22.1% vs. 62.8 ± 16.2%), higher light PA intensity (44.7 ± 20.4% vs. 36.4 ± 17.0%), and a higher step count (503.0 ± 345.4 vs. 291.0 ± 143.1) than the Flower Fest, although not significantly. Tasks requiring cardiovascular effort and strength were rated as more physically demanding. Most participants found the system user-friendly and showed interest in continued use, though technical support was essential due to limited familiarity with VR. The findings suggest FitFest has potential to promote light PA in older adults, highlighting the importance of usability and support in tech-based interventions.

BackgroundPhysical inactivity remains a critical issue among older adults worldwide, contributing to functional decline and increased health risks. Traditional exercise programs face barriers such as accessibility and motivation. Web-based home exercise programs offer a scalable and accessible solution. This study examined the effects of a 12-week web-based, short-duration, and high-frequency light-intensity aerobic dance exercise program on body composition, physical function, and physical activity levels in older adults.MethodsEighty-one older adults were randomly assigned to an exercise group (n = 41) or control group (n = 40). The exercise group participated in a 12-week home-based online program consisting of 20-minute light-intensity aerobic dance sessions held on weekday mornings. The control group maintained their usual lifestyle. Body composition, physical function, and physical activity levels were assessed before and after the intervention.ResultsSeventy-one participants (36 in the exercise group and 35 in the control group) completed the study. The exercise group significantly improved the maximal walking speed by 0.10 m/s compared with the control group, with no significant between-group differences in body composition, physical activity levels, and other physical function outcomes. The adherence rate was 94.5%, indicating high feasibility of the intervention.ConclusionsThe 12-week web-based aerobic dance exercise program selectively improved walking speed, suggesting its potential to enhance a specific aspect of locomotor function in older adults. Given their accessibility and scalability, web-based interventions may help in promoting functional independence and healthy aging. Future research should explore the long-term effects and optimize the program to maximize its impact.Trial registrationThis study was registered in the UMIN Clinical Trials Registry (UMIN000044758, registered on 5 July 2021).Supplementary InformationThe online version contains supplementary material available at 10.1186/s12877-025-06495-3.

IntroductionWith the global population ageing rapidly, older adults face increased risks of physical and cognitive decline. Despite the well-documented benefits of physical activity (PA), many older adults fail to meet PA guidelines. Mobile health (mHealth) apps offer promising tools to promote PA, but user engagement remains a challenge. In response, the MIA app was co-created with older adults using the Behavior Change Wheel framework to enhance usability, relevance and sustained engagement. A feasibility study showed promising results in usability and user satisfaction, supporting further evaluation. The goal of this study is to evaluate the effectiveness of MIA on PA promotion in older adults.Methods and analysisA randomised controlled trial conducted in Belgium at a university college will assess the effectiveness of the MIA app in promoting PA in older adults. Participants will be randomly assigned in a 1:1 ratio to either the intervention group (MIA app use) or the control group (no use of MIA) for 8 weeks. The primary outcome is moderate-to-vigorous PA, measured via Garmin wearable devices. Secondary outcomes include self-reported measures (PA, well-being, user satisfaction), clinical assessments (physical and cognitive functioning) and time series assessments (daily steps). A total of 75 participants will be recruited to ensure sufficient power, accounting for dropout. Eligible participants must be ≥65 years, medically stable, have no significant cognitive or physical limitations, understand and speak Dutch and have access to a smartphone and/or computer. Exclusion criteria include an active lifestyle, participation in other exercise programmes or clinical trials, or any condition deemed by a healthcare professional to compromise safety or study validity.Ethics and disseminationThe study was approved by the UHasselt Medical Ethics Committee (B1152025000012) and complies with Belgian legislation on human research. Written informed consent will be obtained from all participants prior to enrolment. Data will be securely stored for up to 25 years. Results will be disseminated via peer-reviewed publications and conference presentations.Trial registration numberNCT06983574.

Older adults often face daily problems that can interfere with physical activity. Although individual self-efficacy (confidence in one's own abilities) is known to promote physical activity, it overlooks the social influences in older adults' lives. Relation-inferred self-efficacy (the belief that a close other has confidence in one's abilities) may provide additional insight. This study explored associations between daily problems, individual self-efficacy, and relation-inferred self-efficacy with physical activity (moderate to vigorous physical activity and steps). It also examined whether individual and relation-inferred self-efficacy moderate the relationship between daily problems and physical activity. A sample of 226 community-dwelling older adults (109 couples and eight individuals) wore accelerometers for up to 7 days to track daily physical activity. Participants also reported daily problems and levels of self-efficacy. Multilevel models were used to examine the associations of self-efficacy and daily challenges with physical activity and to test moderation effects of self-efficacy on the problem-physical activity relationship. Both individual and relation-inferred self-efficacy were positively associated with physical activity when examined separately. However, when modeled together, only relation-inferred self-efficacy remained a significant predictor. Daily problems were not significantly related to physical activity, and there were no significant moderation effects of self-efficacy on the problem-physical activity relationship. These findings suggest that relation-inferred self-efficacy might be more important than individual self-efficacy for physical activity among older adults, emphasizing the role of social context. Significance/Implications: Interventions promoting physical activity in older adults may benefit from incorporating support from close others to enhance relation-inferred self-efficacy.

Ageing is a natural biological process accompanied by a spectrum of physiological and psychological challenges. Regular physical activity is crucial for preserving health and functional capacity in older adults. This cross-sectional study examined the relationships between physical activity levels, self-efficacy, and peer-based social support among adults aged 65–75 years in Rasht, northern Iran. A total of 550 individuals were recruited through systematic random sampling from comprehensive health centers. The participants completed the validated Persian versions of the International Physical Activity Questionnaire–Short Form (IPAQ-SF), the Self-Efficacy for Physical Activity Questionnaire, and a peer-based social support scale. Statistical analyses were conducted via SPSS version 25. Multivariate ordinal logistic regression indicated that higher self-regulation scores, a key subdomain of self-efficacy, were significantly associated with greater physical activity levels (P < 0.001). Older adults with higher educational attainment engaged in significantly more physical activity (aOR = 2.10, P = 0.035), whereas those with activity-limiting conditions reported lower activity levels (aOR = 0.58, P = 0.003). Peer-based social support was positively correlated with self-efficacy but was not directly associated with physical activity. These findings can inform the development of targeted strategies in geriatric health promotion programs, emphasizing the enhancement of self-regulation skills and the role of education in fostering physical activity.Supplementary InformationThe online version contains supplementary material available at 10.1038/s41598-025-20717-z.

Exercise and physical activity are widely promoted as an effective means of improving the health and physical functioning of older adults. Walking as a recreational activity is one of the safest and most appropriate forms of physical activity for older adults. The aim of the study was to explain, by searching the available literature, how different walking models affect the health-related fitness parameters of the elderly. The search and anal- ysis of the studies were done in accordance with the PRISMA guidelines, and the study protocol was registered with PROSPERO, number CRD42023461140. An electronic databases search (Google Scholar, PubMed, Mendeley, Science Direct, and Scopus) yielded 225 relevant studies conducted in the last 15 years. A total of 15 studies were included in the qualitative synthesis, which analyzed the effects of different types of walking, such as Nordic walking, normal walking, and other unconventional walking programs, such as dog walking, ecological walk- ing, walking with ankle weights, and continuous stair walking, on various health fitness variables in the older population. Nordic walking has been shown to be an effective exercise for improving body composition, cardio- vascular fitness, motor abilities, and balance in the elderly individuals. Normal walking has also been found to positively influence body composition and muscle strength, while improving VO2max, balance, and flexibility. Unconventional walking programs such as dog walking, ecological walking, walking with ankle weights, and continuous stair walking have also shown positive results in improving aerobic endurance, leg strength, upper limb strength, and functionality of heart capacity. However, it is important to ensure proper intensity and volume of training to avoid potential negative outcomes, such as an increase in subcutaneous fat or overtraining. Overall, walking programs can be an effective and accessible way for elderly individuals to improve their physical fitness and overall health. The obtained results indicate the necessity of physical activity in old age in order to lead a quality and healthy life.

Healthy aging involves consistently maximizing opportunities to maintain and enhance physical and mental well-being, fostering independence, and sustaining a high quality of life. This review examines recent technological innovations aimed at promoting the well-being of older adults. The scope encompasses wearable devices and telemedicine, showcasing their potential to enhance the health and overall well-being of older individuals. The review highlights the crucial role of assistive technologies, including mobility aids, hearing aids, and adaptive home devices, in addressing the specific challenges associated with aging. The relevant literature was collected and selected based on the objective of the study and reviewed. Digital technologies, including brain-computer interfaces (BCIs), are explored as potential solutions to enhance communication between healthcare providers and aging patients, considering engagement levels and active interaction. Sophisticated BCIs, such as electroencephalograms, electrocorticography, and signal modeling for real-time identification, play a crucial role in event detection, with machine learning algorithms enhancing signal processing for accurate decoding. The exploration of smart wearable systems for health monitoring emerges as a dynamic and promising field in the context of aging. Fitbit® showcases accurate step counting, making it suitable for monitoring physical activity in older adults engaged in slow walking. ActiGraph™ is evaluated for accuracy in monitoring physical activity in older adults, with results indicating reliable concurrence with Fitbit® devices. The study identifies several limitations, including sample size constraints, challenges in keeping pace with technological advancements, and the need for further investigation into the suitability of fitness trackers for individuals with significant mobility impairments. The evolving landscape of wearable technologies, exemplified by Fitbit®, Acti- Graph™, and other interventions, holds substantial promise for reshaping healthcare approaches for the aging population. Addressing the limitations will be crucial as research progresses to ensure the effective and ethical integration of wearables into geriatric care, maximizing their potential benefits.

BackgroundAccurate measurement of physical activity (PA) is key to identifying determinants of health and developing appropriate interventions. Self-reports of PA (eg, in surveys or diary studies) often suffer from measurement error. Providing study participants with wearable devices that passively track PA reduces reactivity and recall error but participants’ noncompliance and high device costs are problematic. Many older adults now have smartphones that track PA. Based on legal requirements, data controllers (eg, health apps) must provide users with access to their data, and individuals can request and donate these data for research. This user-centric approach provides researchers with access to individual-level data, and it gives users control over what data are shared.ObjectiveWe conduct a first test of the data donation approach for PA data among older adults. We study (1) how willing and successful older adults are to donate their PA data from different smartphone apps, (2) what drives donation of PA data at the different stages of participation, and (3) what biases arise from selective data donation.MethodsTo answer our research questions, we use cross-sectional observational data from a probability-based online panel of the Dutch general population. A total of 2086 members of the Longitudinal Internet Studies for the Social Sciences panel aged 50 years and older completed a web survey in 2024. All iPhone and Android smartphone owners were asked to download passively collected PA data from their devices (Apple Health, Google Location History, or Samsung Health) and donate them via the Port platform.ResultsOut of the 2086 survey participants, 1889 (91%) reported owning an iPhone or Android phone compatible for data donation, 606 (29%) reported willingness to donate PA data, 354 (17%) started the data donation, and 256 (12%) successfully provided a data package. Gender, age, educational attainment, monthly personal net income, smartphone usage behavior, privacy- and trust-related attitudes, and type of health app from which the data were requested correlated with behavior at the different stages of study participation. Self-reported reasons for nonwillingness to donate related mainly to expected technical issues, privacy concerns, and perceived usefulness. Compared with the entire sample, data donors reported better health, fewer health-related limitations, fewer difficulties performing tasks, and more PA.ConclusionsOur study shows that data donation from smartphones as part of a probability-based web survey of older adults is a feasible alternative for the measurement of PA, especially for iPhone owners younger than 70 years. Limitations relate to nonparticipation which correlates strongly with characteristics of smartphone ownership and comfort with device use. Substantive bias in health and PA outcomes persists for those who donated in comparison with all survey respondents.

AimTo examine the factors influencing physical activity among community-dwelling older adults with type 2 diabetes in China, and to provide a strong theoretical framework and empirical support for creating more individualized and scientific strategies for improving physical activity.MethodsThe text was analyzed by the innovative combination of traditional thematic analysis method and topic modeling (python machine learning) through the qualitative study, aiming to deeply explore the experiences and views of older adults with type 2 diabetes in the community regarding physical activity. Quantitative study adopted a cross-sectional survey to objectively and efficiently discover causal relationships among data. Finally, the results from the two different researches were compared to identify differences, similarities, and contradictions, enabling mutual verification and supplementation of the research findings and compensating for the limitations of a single research method, thereby obtaining the ultimate results.ResultsWe compared and integrated the qualitative and quantitative study results, and finally determined 11 topics, including 23 key factors, as the set of the study results of this study.ConclusionFrom the perspective of Multi-theory model, this study explored the related factors influencing the physical activity of older adults with type 2 diabetes in the community through a mixed-methods study. By comparing and integrating the results of qualitative and quantitative studies, we finally identified 11 topics, including 23 key factors, as the results of this study, such as “Focus on physical activity itself,” “The persistence of physical activity,” and “Traditional conception,” which were not mentioned in previous systematic literature search. These new discoveries provide a empirical support for creating more individualized and scientific strategies for improving physical activity behaviors among older adults with type 2 diabetes in the community.

Purpose: Patient motivation is essential for successful rehabilitation, so apathy may hinder physiotherapists’ interventions aimed at increasing physical activity. We examined the relationship between apathy and physical activity to identify the factors that influence it. Methods: Pearson product-moment correlations were pooled from eligible studies to examine the relationship between apathy and physical activity. Subgroup meta-analyses and meta-regressions were also conducted. Results: From the systematic review (28 articles) and main meta-analysis (22 studies; 12,541 participants), the results showed a negative correlation between apathy and physical activity ( r = −0.13; 95% CI: −0.18, −0.09; p &lt; 0.0001 based on Pearson’s r-values; r = −0.40; 95% CI: −0.68, −0.02; p = 0.043 based on Spearman’s ρ-values). The correlation was statistically significant in patients with Parkinson’s disease and in older adults who were healthy, depressed, fallers, or had mild cognitive impairment. A meta-regression showed an effect of age, with a stronger correlation between apathy and physical activity in older adults compared to younger adults ( p = 0.003). Conclusion: Higher levels of apathy are associated with lower levels of physical activity, and this negative association is stronger with age. Therefore, apathy may limit exercise therapy efficacy and carry prognostic implications for patients whose condition requires physical activity.

ObjectiveThis study investigated the relationships between functional mobility and cognitive performance, sleep quality and physical activity in older adults according to age, sex, weight status and education, and whether these variables could be predictors of functional mobility and fall risk.MethodEighty-five physically independent older adults (72.3 ± 5.67 years; 83.5% female), without significant cognitive impairments, were involved in this cross-sectional study. Functional mobility, cognitive functions as phonemic fluency, attention, memory, processing speed, and manual dexterity were, respectively, assessed with Timed Up and Go (TUG) test, phonemic fluency test, Grooved Pegboard Test, (GPT) and Symbol Digit Modalities Test, Stroop Color-Word Test. Sleep quality and physical activity were evaluated with self-reported questionnaires. Correlational and multiple regression analyses were performed.ResultsPoorer TUG performance was significantly associated with older age (ρ = 0.46, p < 0.001), lower educational level, reduced GPT performance, and lower scores on working memory, and processing speed. Age and GPT performance showed the strongest associations with TUG results. Regression analysis confirmed age and manual dexterity as significant predictors of functional mobility.ConclusionOlder age and reduced manual dexterity were linked to greater fall risk. These findings suggest that early interventions targeting fine motor skills may help preserve mobility and prevent falls in aging populations.

IntroductionOlder adults in East Tennessee (TN), the fastest growing demographic, face significant health challenges, with 44% reporting four or more chronic conditions. The state ranks 45th in physical inactivity among older adults, exacerbating chronic disease risks, fall-related injuries, and mental health issues. Urban-rural disparities in East TN further complicate efforts to promote active living, particularly for rural residents.PurposeThis qualitative study explored socioecological barriers and solutions to increase physical activity (PA).MethodsIn April 2024, two focus group were conducted in East TN, with a total of 11 participants composed of six community partners and five older adults. A semi-structured interview guide explored PA attitudes, beliefs, and behaviors and gathered recommendations for increasing physical activities among older adults. Data were analyzed thematically using a socioecological framework at individual, organizational, and community levels.ResultsBarriers at the individual level included poor physical, psychological, and social health, and low digital literacy skills. Organizational-level barriers included limited capacity to support PA programming (e.g., staffing, facilities, and funding limitations) and overlapping community program efforts. Community level barriers included limited social support networks and inadequately built environmental features for active living. Solutions highlighted the role of relationships (e.g., peer-to-peer, trusted facilitators) at the individual level, tailored programming and marketing efforts at the organizational level, and leveraging local resources and multi-system collaborations at the community level.ImplicationsThe findings highlight socioecological factors contributing to physical inactivity in East TN older adults and identifies strategies to address them. These findings can inform sustainable, multi-systems interventions to promote PA in the region.

Designing strategies to improve physical activity in older adults with age-related hearing loss in China: A qualitative study using the behavior change wheel.

BackgroundPhysical inactivity is a major global public health issue and ranks as the fourth leading modifiable risk factor for mortality from noncommunicable diseases and a major cause of disability. One of the questionnaires used to assess levels of physical activity in older adults is the Physical Activity Scale for the Elderly (PASE). The aim of this study was to determine the cut-off value of the PASE for physical inactivity in older adults.MethodsThis was a cross-sectional study. The study was conducted at Hacettepe University. In the course of the study, 420 older adults were included on the basis of the established inclusion criteria. Of these, 394 voluntarily agreed to participate. Older adults’ physical activity levels were assessed via the International Physical Activity Questionnaire-Short Form (IPAQ-Short Form) and the PASE. Participants categorized as low/inactive according to the IPAQ scale were classified as physically inactive. Conversely, those categorized as moderate or high activity were classified as physically active. This classification scheme was subsequently utilized to determine the physical inactivity threshold of the PASE.ResultsThe physical inactivity cut-off point for the PASE score in older adults was a score of 67. For identifying physical inactivity, a PASE score of ≤ 67 has a sensitivity of 0.76 and a specificity of 0.61. Among the 394 older adults who participated in the study, 163 were in the inactive group, and 231 were in the active group. The prevalence of physical inactivity was 41.37% in this study.ConclusionsIn the present study, the PASE was found to have moderate sensitivity and specificity in discriminating physical inactivity. It is not a sufficient stand-alone measure for physical inactivity, so it is recommended that the PASE be included as part of a comprehensive physical inactivity assessment in older adults.

Improvement of physical and cognitive capabilities through physical activity (PA) contributes to well-being in older age. Unfortunately, many older adults lack sufficient PA, due to reasons such as PA not being enjoyable for them. As a result, older adults are unable to maintain their motivation for the initiation and continuation of PA. In our previous works, a boxing glove-type sensory augmentation system was developed to solve this problem by inducing enjoyment during PA. However, the effect of our device on physical and cognitive capabilities, which are crucial for well-being, and motivation for initiation and continuation of PA remains unclarified. In this study, we aimed to evaluate these effects. We hypothesized that our device may help improve capabilities, and that the enjoyment it provides may potentially contribute to increased motivation for initiation and continuation of PA. Fourteen healthy older adults participated in the study. Kickboxing lessons for the older adults using our device were conducted a total of five times over a six-week period, and the participants were free to attend the sessions as many times as they wished. They participated in three measurement sessions: pre-measurement before the lesson period, post-lesson measurement after each lesson, and post-measurement at the end of the lesson period to evaluate the effects of our device. Physical capabilities were assessed through two-step, stand-up, and center-of-pressure tests. Cognitive capabilities were assessed using illustration memory and computation tests. Mental state was assessed using a positive and negative affect schedule (PANAS). Subjective evaluations of enjoyment and motivation for the initiation and continuation of PA through the use of our device were also conducted. In the results, physical and cognitive capabilities and mental states tended to improve. Subjective evaluations indicated increased enjoyment from using our device and greater perceived effectiveness in motivating PA initiation and continuation. These evaluations improved over time. While the pre-post design without a control group limits causal interpretation, improvements in physical, cognitive, and mental states may have contributed to enhanced enjoyment. As a result, the device may have the potential to enhance motivation for initiation and continuation PA in older adults.

Introduction: Motor learning is fundamental for the responsiveness to motor therapy and rehabilitation as it involves the capacity to learn, adapt and generalize motor skills. However, motor learning declines with age, compromising the recovery of impaired motor functions. Recent evidence suggests that this age-related decline in motor learning may be associated to poor visuospatial function. There is also growing evidence supporting the role of regular physical activity in improving specific cognitive domains, although the effects on visuospatial abilities are not yet well documented. Thus, the present study aimed to investigate whether the practice of physical activity improves visuospatial abilities in older adults. Method: Sixty healthy adults, aged between 60 and 89 years old, participated in this study. Half of the participants were physically active and the other half was sedentary counterparts. All the participants were administered with Rey-Osterrieth Complex Figure Test. Results: Participants with no regular physical activity performed more poorly in both copy and recall conditions, compared to participants physically active. These intergroup differences reached statistical significance, suggesting that visuospatial processing may benefit from physical activity in older adults. Conclusion: By improving visuospatial function, physical activity will have a critical role on motor skills reacquisition, bringing important implications for geriatric physiotherapy. This is particularly important considering that as we get older we tend to become less responsive to motor rehabilitation.

BackgroundWalking is a fundamental and accessible physical activity (PA) for older adults. Using daily step counts to self-monitor adherence to the World Health Organization’s (WHO) PA guidelines may facilitate health promotion and promote behavioral changes. This study aimed to determine the step count equivalents for achieving 30 min/day and 150 min/week of moderate-to-vigorous PA (MVPA) among older adults in Taiwan.MethodsThis cross-sectional study was conducted from May to August 2023. Community-dwelling adults aged ≥65 years were recruited through convenience sampling from local communities in northern Taiwan, with support from community leaders and activity centers. Participants were required to be capable of walking independently. Daily step counts and MVPA were measured using triaxial accelerometers. Linear regression models, including log-transformed step counts and MVPA, were used to assess equivalence.ResultsIn total, 191 older adults participated in the study (42 males, 149 females). Engaging in 30 min of MVPA daily translated to approximately 8,602 steps/day for males and 8,940 steps/day for females. Weekly MVPA of 150 min was equivalent to approximately 56,028 steps/week for males, 58,988 steps/week for females, and 57,000 steps/week overall (or 8,142 steps/day).ConclusionAmong older adults, reaching at least 8,602 steps/day is a good indicator of meeting the WHO’s recommendation of 30 min/day MVPA, whereas 57,000 steps/week corresponds to 150 min/week of MVPA. These step-based thresholds provide practical and easy-to-understand targets for self-monitoring daily activity levels and offer a behavioral foundation for PA promotion strategies aimed at improving the health of aging populations.

Impact of 4week(s) or more immersive virtual reality on quality of life and physical activity in older adults: a systematic review and meta-analysis (Preprint)

Older adults undergo various physical changes that necessitate consistent efforts to sustain their health, which includes engaging in regular physical activity. Participation in these activities is influenced by multiple factors, one of which is self-regulation. This study aims to investigate the relationship between self-regulation and physical activity among older adults at the Ciptomulyo Health Center. The research employs an analytical method utilizing a cross-sectional design. A total of 374 respondents who met the study's selection criteria were recruited. The Physical Activity Self-Regulation Scale (PASR) and the Physical Activity Scale for the Elderly (PASE) were utilized to evaluate the levels of self-regulation and physical activity, respectively. The collected data were analyzed using the chi-square test. The majority of respondents were female (58.6%), with a significant proportion demonstrating high levels of self-regulation (74.6%) and satisfactory physical activity levels (61.5%). The results established a substantial correlation between self-regulation and physical activity (p = 0.000), suggesting that enhanced self-regulation is associated with increased physical activity. These findings underscore the importance of interventions designed to enhance self-regulation among older adults. By strengthening self-regulation, it is possible to mitigate inactivity and promote a healthier lifestyle. This insight provides a foundational basis for developing strategies that support older adults in maintaining an active and healthy lifestyle by enhancing their self-management skills.

Walking is an accessible and beneficial form of physical activity for older adults. However, when performed under perturbed conditions, it can place greater demands on both neuromuscular control and metabolic efficiency, highlighting the need to better understand the underlying adaptations. We compared stable and perturbed walking on a treadmill at three different speeds in 16 healthy older adults. Muscle synergies were extracted from electromyographic signals of eight lower limb muscles, oxygen uptake (VO2), minute ventilation, heart rate, and rate of perceived exertion (RPE) were also collected. Perturbed walking at 3 km/h increased oxygen uptake (p = 0.003; d = -0.52) and energetic cost (EC; p = 0.003; d = -1.12) compared to the stable condition. VO2 (p < 0.001; = 0.92), EC (p = 0.02; = 0.25) and RPE (χ2 = 4.45; p = 0.04) were higher at 3 km/h than at higher speeds. Four muscle synergies were required to accurately model the neuromuscular control during both conditions. Full-width at half maximum revealed that the transition from stable to perturbed walking led to statistically significant modifications in gait synergy composition (p = 0.01; = 0.04). Weight sparsity revealed no significant differences between conditions. These results suggest that the transition from an accurate to a more robust locomotor control for managing continuous perturbations may come at the expense of increased metabolic demand.