Abstract
Objective
To test the proposed mechanism of action of a task-specific motor learning intervention
by examining its effect on measures of the motor control of gait.
Design
Single-blinded randomized clinical trial.
Setting
University research laboratory.
Participants
Adults (N=40) aged ≥65 years with gait speed >1.0m/s and impaired motor skill (figure-of-8
walk time >8s).
Interventions
The 2 interventions included a task-oriented motor learning and a standard exercise
program; both interventions included strength training. Both lasted 12 weeks, with
twice-weekly, 1-hour, physical therapist–supervised sessions.
Main Outcome Measures
Two measures of the motor control of gait, gait variability and smoothness of walking,
were assessed pre- and postintervention by assessors masked to the treatment arm.
Results
Of 40 randomized subjects, 38 completed the trial (mean age ± SD, 77.1±6.0y). The
motor learning group improved more than the standard group in double-support time
variability (.13m/s vs .05m/s; adjusted difference [AD]=.006, P=.03). Smoothness of walking in the anteroposterior direction improved more in the
motor learning than standard group for all conditions (usual: AD=.53, P=.05; narrow: AD=.56, P=.01; dual task: AD=.57, P=.04). Smoothness of walking in the vertical direction also improved more in the motor
learning than standard group for the narrow-path (AD=.71, P=.01) and dual-task (AD=.89, P=.01) conditions.
Conclusions
Among older adults with subclinical walking difficulty, there is initial evidence
that task-oriented motor learning exercise results in gains in the motor control of
walking, while standard exercise does not. Task-oriented motor learning exercise is
a promising intervention for improving timing and coordination deficits related to
mobility difficulties in older adults, and needs to be evaluated in a definitive larger
trial.
Keywords
List of abbreviations:
AP (anteroposterior), HR (harmonic ratio), ICC (intraclass correlation coefficient), ML (mediolateral), RPE (rating of perceived exertion), V (vertical)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: November 10, 2014
Footnotes
Supported by the Pittsburgh Older Americans Independence Center (grant no. NIA P30 AG024827) and the Beeson Career Development Award (grant no. NIA K23 AG026766).
Clinical Trials Registration No.: PRO09080228.
Disclosures: S.P. reports grants from InRange Systems, Inc, during the conduct of the study. The other authors have nothing to disclose.
Identification
Copyright
© 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
