Can An Innovative Physical Therapy Program Enhance Mobility in Middle-Aged and Older Veterans With Slow Walking Speed? A Randomized Controlled Trial.

OBJECTIVE

To investigate the efficacy of an innovative physical therapy program targeting mobility.

DESIGN

Single-blinded randomized controlled trial.

SETTING

Outpatient care VA regional tertiary care center.

PARTICIPANTS

Community-dwelling middle-aged and older Veterans (N=150) with slow walking speed.

INTERVENTIONS: Live Long Walk Strong (LLWS) is an 8-week, 10 (1-h/session) session outpatient physical therapy program. It was designed to enhance mobility by targeting impairments linked to mobility decline. It was compared with participants within a waitlist control group.

MAIN OUTCOME MEASURES: Walking speed (primary outcome) and secondary outcomes included the Short Physical Performance Battery, Activity Measure for Post-Acute Care, leg power, trunk extensor muscle endurance, gait coordination, and exercise self-efficacy.

RESULTS

We experienced a 25% dropout rate, which was in part because of the COVID-19 pandemic shutdowns of human research. We observed significantly faster (P<.05) walking speed (mean 0.08±0.02 m/s) after 8 weeks among LLWS participants. Similarly, there were significant improvements in Short Physical Performance Battery (0.95±0.32) and Activity Measure for Post-Acute Care (2.1±0.8) among LLWS participants. We also observed significantly greater improvements in leg power and self-efficacy among LLWS participants. No significant differences were observed for trunk muscle endurance or gait coordination; however, significantly greater improvement in gait coordination was observed within sensitivity analyses.

CONCLUSIONS

Our study demonstrates that LLWS enabled statistically significant and clinically meaningful gains in mobility among middle-aged and older adult Veterans with slow walking speed. Future analyses of this clinical trial will be able to evaluate long-term outcomes and be better powered to evaluate changes in the attributes LLWS targets.