title: Callosal hyperintensities and gait speed gain from two types of mobility interventions in older adults.
abstract: OBJECTIVE
  To assess whether the volume of callosal hyperintensities in the genu and splenium of older adults with mobility impairment is differentially associated with the degree of gain in gait speed after 2 types of gait interventions.
  
  
  METHODS
  Single-blind randomized controlled trial of 2 types of gait exercises in older adults.
  
  
  METHODS
  Research center in an academic institution.
  
  
  METHODS
  Ambulatory adults (N=44) aged ≥65 years with a slow and variable gait.
  
  
  METHODS
  Twelve-week physical therapist-guided trial of a conventional walking, endurance, balance, and strength (WEBS) intervention (n=20) versus a timing and coordination of gait (TC) intervention (n=22).
  
  
  METHODS
  Gain in gait speed after the intervention and its relation to callosal hyperintensities in the genu and splenium of the corpus callosum.
  
  
  RESULTS
  Gait speed improved in both the WEBS group (mean change, 0.16m/s) and the TC group (mean change, 0.21m/s; both P<.05). The volume of white matter hypertintensities (WMHs) in the genu was differentially associated with gait speed gain (group × genual WMH interaction, P=.05). Greater genual WMH volume was related to a smaller gait speed gain in the WEBS group (P=.01) but not in the TC (P=.10) group. Splenial WMH volume was not differentially associated with gait speed gain (interaction, P=.90).
  
  
  CONCLUSIONS
  Callosal hyperintensities differentially influence gait speed gain by the type of gait rehabilitation. Mobility impaired older adults with genual hyperintensities may benefit from a rehabilitation program focused on motor skill learning rather than on strength and endurance training.
authors.affiliation: Division of Geriatric Medicine and Gerontology, Department of Medicine, University of Pittsburgh, Pittsburgh, PA. Electronic address: nkn3@pitt.edu.
authors.forename: Neelesh K
authors.initials: NK
authors.lastname: Nadkarni
authors.affiliation: Division of Geriatric Medicine and Gerontology, Department of Medicine, University of Pittsburgh, Pittsburgh, PA.
authors.forename: Subashan
authors.initials: S
authors.lastname: Perera
authors.affiliation: Division of Geriatric Medicine and Gerontology, Department of Medicine, University of Pittsburgh, Pittsburgh, PA.
authors.forename: Stephanie A
authors.initials: SA
authors.lastname: Studenski
authors.affiliation: Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA.
authors.forename: Caterina
authors.initials: C
authors.lastname: Rosano
authors.affiliation: Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA.
authors.forename: Howard J
authors.initials: HJ
authors.lastname: Aizenstein
authors.affiliation: Department of Physical Therapy, University of Pittsburgh, Pittsburgh, PA.
authors.forename: Jessie M
authors.initials: JM
authors.lastname: VanSwearingen
mesh_terms: D000368:Aged; D003337:Corpus Callosum / Q000473:pathology*; D005260:Female; D005684:Gait / Q000502:physiology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D051346:Mobility Limitation; D053580:Muscle Strength / Q000502:physiology; D010807:Physical Endurance / Q000502:physiology; D026741:Physical Therapy Modalities; D004856:Postural Balance / Q000502:physiology; D016037:Single-Blind Method; D016138:Walking / Q000502:physiology
keywords: Cerebral small-vessel disease; Cognition; Corpus callosum; Exercise; Intervention; Mobility; Rehabilitation