JMIR Publications

ABSTRACT

Background:

Walking difficulties are a common, costly problem, however disability associated with the decline in walking ability is not an inevitable consequence. With an aging population, it is increasingly important to establish strategies to help older adults preserve the capacity to live independently and to function well during late life. Preclinical mobility limitation (PCML), which is characterized by subtle changes or limitations in mobility that precede disability, manifests as changes in how daily tasks such as walking are performed. Persons with PCML are at increased risk for the onset of disability and chronic disease. For that reason, PCML is a critical stage in the natural history of functional change when there is the opportunity for primary prevention interventions.

Objective:

To determine if a 12-week mobility program called STEPPING-UP is more effective than a Telephone-Based Coaching Walking Program (TELE) or a Chair-Based Yoga Program (YOGA) at improving walking speed.

Methods:

This randomized controlled trial (RCT) will recruit 249 older adults (aged 55-75 years) with preclinical mobility limitation (PCML) to evaluate the effect of a 12-week virtual mobility self-management program (STEPPING-UP) compared to a telephone-based coaching walking program (TELE) and a virtual chair-based yoga program (YOGA) on walking speed, aerobic exercise capacity, dual-task cost, physical functioning (balance, strength), balance confidence, extent of community mobility, self-management of mobility, and quality of life. Programs will be delivered over 12 weeks and participants will undergo virtual assessments with a blinded physiotherapist at baseline, 12, 24 and 36 weeks. An economic evaluation will be conducted alongside this RCT.

Results:

Pending.

Conclusions:

To date, PCML has not been addressed by primary prevention interventions that incorporate both task-oriented motor learning exercise and mobility self-management sessions. Results will establish if the STEPPING-UP program has the potential to serve as a model for sustainable, accessible and cost-effective programming for individuals with early mobility limitations. Clinical Trial: ClinicalTrials.gov ID NCT04368949. Registered 04/23/2020.