Effect of exercise on motor skill of walking among community-dwelling older adults: secondary outcomes of a randomized clinical trial
Jessie VanSwearingen, Subashan Perera, Jennifer BrachAbstract
Background
Both standard impairment-based and motor learning exercise have improved walking speed. Less known is the impact of the interventions on the motor skill of walking. In older adults with walking problems, intervention effects of standard exercise with added components of motor learning exercise (standard plus) were compared to standard exercise alone on the motor skill of walking.
Methods
Community-dwelling older adults (≥65 years of age) were randomized to 12-week interventions, standard plus (n = 124) or standard exercise alone (n = 125). Motor skill of walking outcomes of oxygen cost of walking, gait variability, smoothness of walking and the walk ratio were recorded at 12 weeks, and in follow up at 24 and 36 weeks.
Results
The older adults (n = 249) had a mean ± SD age of 77.4 ± 6.6 years, mean ± SD walking speed, 1.07 ± 0.17 m/s. No differences between groups observed in the motor skill of walking outcomes at any time point, except change in stance time variability at 24 weeks, in standard plus, mean ± SD −0.003 ± 0.012 compared to standard, mean ± SD 0.006 ± 0.071, adjusted difference ± SE, −0.0098 ± 0.0040, P = .0154, likely a spurious finding. Oxygen cost of walking improved after both interventions, standard plus, change in the oxygen cost, mean ± SD, −0.052 ± 0.060 ml/kg m at 12 weeks, −0.047 ± 0.057 ml/kg m at 24 weeks and −0.041 ± 0.061 ml/kg m at 36 weeks and in standard, mean ± SD, −0.046 ± 0.062 ml/kg m at 12 weeks, −0.039 ± 0.066 ml/kg m at 24 weeks and −0.041 ± 0.073 ml/kg m at 36 weeks, all P < .0001, and stance time variability improved in standard plus at 12 weeks, mean ± SD, −0.002 ± 0.013, maintained at 24 and 36 weeks; the change at 12 weeks nonsignificant with multiplicity correction.
Conclusions
There were no differences in the motor skill of walking outcomes between the intervention groups. Oxygen cost of walking improved after both the standard and the standard plus timing and coordination exercise and the improvement sustained without continued exercise for 24 weeks after intervention.
ClinicalTrials.gov Identifier
NCT02663778.