Translation of a Motor Learning Walking Rehabilitation Program Into a Group-Based Exercise Program for Community-Dwelling Older Adults.
Traditional exercise programs for older adults, which focus on aerobic and strength training, have had only modest effects on walking. Recently, a motor learning exercise program was shown to have greater effects on walking compared with a traditional exercise program. Translating this novel motor learning exercise program into a group exercise program would allow it to be offered as an evidence-based, community-based program for older adults.



To translate a walking rehabilitation program based on motor learning theory from one-on-one to group delivery (On the Move) and evaluate multiple aspects of implementation in older adults with impaired mobility.



The translation process involved multiple iterations, including meetings of experts in the field (Phase I), focus groups (Phase II), and implementation of the newly developed program (Phase III). Phase III was based on a one-group model of intervention development for feasibility, safety, potential effects, and acceptability.



Community sites, including 2 independent living facilities, an apartment building, and a community center.



Adults 65 years of age or older who could ambulate independently and who were medically stable. Thirty-one adults, mean age 82.3 ± 5.6 years, were eligible to participate.



The group exercise program was held twice a week for 12 weeks.



Acceptability of the program was determined by retention and adherence rates and a satisfaction survey. Risk was measured by adverse events and questions on perceived challenge and safety. Mobility was assessed pre- and postintervention by gait speed, Figure of 8 Walk Test, and 6-minute walk test.



Modifications to the program included adjustments to format/length, music, education, and group interaction. The 12-week program was completed by 24 of 31 entrants (77%). Adherence was high, with participants attending on average 83% of the classes. Safety was excellent, with only 1 subject experiencing a controlled, noninjurious fall. There was preliminary evidence for improved mobility after the intervention: gait speed improved from 0.76 ± 0.21 to 0.81 ± 0.22 m/s, P = .06; Figure of 8 Walk Test from 13.0 ± 3.9 to 12.0 ± 3.9 seconds, P = .07; and 6-minute walk test from 246 ± 75 to 281 ± 67 m, P = .02.



The group-based program was safe and acceptable to older adults with impaired mobility and resulted in potentially clinically meaningful improvements in mobility.
Department of Physical Therapy, School of Health and Rehabilitation Sciences, University of Pittsburgh, Bridgeside Point 1, 100 Technology Drive, Pittsburgh, PA 15219(∗). Electronic address: jbrach@pitt.edu.
Jennifer S
JS
Brach
Program in Physical Therapy, Washington University, St. Louis, MO(†).
Sara J
SJ
Francois
Department of Physical Therapy, University of Pittsburgh, Pittsburgh, PA(‡).
Jessie M
JM
VanSwearingen
University of Pittsburgh Medical Center, Community Provider Services, Pittsburgh, PA(§).
Sandra
S
Gilmore
Division of Geriatric Medicine, Department of Medicine and Department of Biostatistics, University of Pittsburgh, Pittsburgh, PA(¶).
Subashan
S
Perera
National Institute on Aging, Baltimore, MD(#).
Stephanie A
SA
Studenski
D000368:Aged; D000369:Aged, 80 and over; D015444:Exercise; D005081:Exercise Therapy; D006801:Humans; D057187:Independent Living; D055070:Resistance Training; D016138:Walking