title: Effect of treadmill training on specific gait parameters in older adults with frailty:  case series.
abstract: OBJECTIVE
  Treadmill-walking training (TWT) as an intervention to improve the gait of frail older adults has not been well studied. In this pilot study, we describe the feasibility, tolerance, and effect of TWT on specific gait parameters during overground walking in 4 frail older adults as a prelude to developing larger-scale exercise intervention trials in this high-risk population.
  
  
  METHODS
  Four community-residing frail older individuals (age > 70 years) with Mini-Mental State Examination score of 26 or higher and no activity limitations. Frailty was defined as the presence of at least 3 of the following 5 attributes: slow gait (<1 m/s); unintentional weight loss (>10 lb in prior year); self-report of poor grip strength; exhaustion; and low level of physical activity.
  
  
  METHODS
  The TWT consisted of 24 sessions (3 times per week for 8 weeks). Five quantitative gait parameters (velocity, stride length, swing time, percentage of double support phase, and coefficient of variation [COV] of stride length) during overground walking were measured at baseline, weekly during training, and immediately post-TWT.
  
  
  RESULTS
  All participants tolerated TWT without significant complications. Following TWT, gait velocity increased in all participants by 6.4 to 26.8 cm/s, which was larger than the reported value for meaningful change in gait velocity (4 cm/s). Stride length and double support phase also showed improvement in all participants (mean percentage increase of 10.8% for stride length and 17.1% reduction for double support phase posttraining compared with baseline). Swing time improved in 3 participants (mean reduction of 4.5%). The COV of stride length did not show consistent improvement.
  
  
  CONCLUSIONS
  This case series shows that TWT is feasible and well tolerated by frail older adults and may improve most gait parameters in this high-risk population.
authors: Department of Physical Medicine and Rehabilitation, Albert Einstein College of Medicine, Bronx, New York 10461, USA. mohpark@montefiore.org
authors: Mooyeon
authors: M
authors: Oh-Park
authors: Roee
authors: R
authors: Holtzer
authors: Jeannette
authors: J
authors: Mahoney
authors: Cuiling
authors: C
authors: Wang
authors: Joe
authors: J
authors: Verghese
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005081:Exercise Therapy / Q000295:instrumentation / Q000379:methods*; D005260:Female; D005684:Gait; D006801:Humans; D008297:Male; D012111:Residence Characteristics; D016138:Walking / Q000502:physiology / Q000592:standards* / Q000706:statistics & numerical data