Journal of Geriatric Physical Therapy:
Physical Therapy, UTMB, Galveston, TX.
Purpose/Hypothesis: The purpose of this study was to pilot test a function‐focused exercise intervention consisting of strength and gait speed training in elders with reduced walking speed, decreased walking endurance, and functional impairment. Subjects: Twelve subjects, 77.2 years old (± 7.34), whose usual gait speed was <0.85 m/s, with walking endurance of < 305 m in 5‐minutes, and who were functionally impaired. Materials/Methods: Subjects were tested for usual and fastest gait speed, 5‐min walk distance, gait energy costs/meter walked, lower extremity muscle strength, timed step test and floor transfer, and the Short Physical Performance Battery pre‐, after 6 and 12 weeks of training, and for follow‐up. Subjects participated in a moderate intensity exercise intervention. The training occurred 3 times per week, 75 minutes per session for 3 months, and combined gait speed training, walking exercise, and functional strengthening. Data were analyzed using an analysis of variance with repeated measures for time and appropriate post‐hoc comparisons. Results: The subjects demonstrated mean usual gait speeds (1.06 (± 0.15 m/s), endurance (359.3m ± 52.5), and functional ability (chair stands = 8.6s ±1.9; step test = 0.58steps/s ± 0.11; floor transfer = 0.071 transfers/s ± 0.017; Short Physical Performance Battery = 11.17 ± 0.13) that were within normal limits after 12 weeks of training. Fastest gait speed (1.58 ± 0.25) and muscle strength also improved significantly. Improvements were maintained during follow‐up testing. Conclusions: This innovative 12 week intervention for frail, mobility disabled subjects led to improvements in walking, function and strength. Clinical Relevance: An appropriately targeted, task specific intervention can reduce or eliminate mobility disabilities in frail elders and, thus reduce the risk for falls, dependency and further functional decline.