WASHINGTON – An exercise program designed to overcome neural deficits improved elders' walking more than physical therapy that focused on lower-body muscles did, results of a randomized, controlled trial of the two approaches show.
Standard physical therapy aimed at building strength, flexibility, balance, and endurance has been shown to improve gait in older adults, but only modestly, said Jessie Van Swearingen, Ph.D., a physical therapist and rehabilitation specialist at the University of Pittsburgh. So she and her colleagues looked for an option.
“There is evidence that the brain has a significant impact on gait,” she said while presenting the study at the annual meeting of the American Geriatrics Society. “We thought about motor learning because changes in gray-matter volume have been associated with slow speed and gait changes.”
“Motor-learning” exercises involve goal-oriented stepping and walking, such as practicing stepping across and behind. Dr. Dr. Van Swearingen and her colleagues randomized 25 community-dwelling adults (average age 77 years) with gait problems to each of the interventions, which then took place in small group settings under the supervision of a physical therapist. Each group participated in 40- to 60-minute activity sessions twice a week for 12 weeks. Each session included 20–30 minutes of walking. Three people dropped out of the study for reasons unrelated to either intervention.
The motor-learning group practiced walking patterns including ovals, spirals, and serpentine paths. As the participants improved, they advanced to more-challenging walking patterns.
Participants in both groups showed improvements in gait abnormalities and walking speed during the study, but the motor-learning group's average improvements were significantly better than those of the standard group. Neither group reported a difference in perceived exertion after the interventions. Dr. Van Swearingen stated that she had no relevant financial conflict to disclose.