The purpose of the study is to examine the effect of a an intervention to improve walking based on motor learning (skill-based) compared to the usual intervention (strength, flexibility and balance - based) on clinical, psychological and laboratory measures of walking and balance of older adults with mobility disability (walking problems).

Condition	Intervention	Phase
Gait Impairment	Behavior: gait intervention	Phase II

Further Study Details: 

Primary Outcomes: Change in gait variability, energy cost of walking, perception of effort in walking, and adaptability of gait to changing environmental conditions, pre and post intervention (12 weeks)
Secondary Outcomes: Physical activity, endurance in walking, falls efficacy, performance of usual activities of living, pre and post intervention (12 weeks)
Expected Total Enrollment:  48

While therapeutic exercise to improve mobility and balance appears to improve physical performance and may reduce falls,1 less is known about the responsiveness to specific interventions or the relation between response to intervention and the underlying problems or impairments. Therapeutic approaches for improving mobility and reducing fall risk are heterogeneous, but do not consistently focus on problem solving as a method of enhancing motor control or skill, an approach that has been found to be important for motor learning in animal models.

This two-year pilot study will allows us to compare the clinical, psychological and laboratory outcomes after a motor-learning based and an impairment-targeted exercise intervention to improve walking in older adults. All subjects will participate in pre and post intervention testing and a 12 week exercise intervention for gait involving either a motor learning (skill enhancement) or impairment-targeted (lower extremity strengthening, flexibility and gait cues).

Ages Eligible for Study:  65 Years and above,  Genders Eligible for Study:  Both

Criteria

Inclusion Criteria:

• 65 years of age and older
• Ambulatory (with or without a straight cane, and without the assistance of another person)
• Have written approval/clearance of their physician to participate in low to moderate intensity, supervised exercise as is characteristic of the interventions for improving gait.
• Difficulty with walking or balance as indicated by the following two criteria during baseline testing:

mild to moderate slowing of walking speed (walking speed ≥ .6m/s and ≤ 1.0m/s) and, gait variability (step length coefficient of variability, CV > 4.5%, or step width CV < 7% or > 30%)

Exclusion Criteria:

-

Please refer to this study by ClinicalTrials.gov identifier  NCT00177359

Lisa DeSantes      412-692-2462 

Pennsylvania
      University of Pittsburgh, Pittsburgh,  Pennsylvania,  15213,  United States

Study chairs or principal investigators

Jessie VanSwearingen, PhD, PT,  Principal Investigator,  University of Pittsburgh   

Study ID Numbers:  0508137
Last Updated:  September 14, 2005
Record first received:  September 12, 2005
ClinicalTrials.gov Identifier:  NCT00177359
Health Authority: United States: Institutional Review Board
ClinicalTrials.gov processed this record on 2005-09-20