Tailored Walking Interventions for Older Adults: Maximizing Outcomes through Personalization
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Matching walking interventions to individual characteristics can significantly enhance outcomes for older adults experiencing mobility challenges. A recent study from UPitt’s Department of Physical Therapy and Division of Geriatric Medicine investigated the predictors of gait speed improvement among 236 participants aged 65 and older who underwent one of two walking programs: Standard (focusing on endurance and strength) and Plus (adding task-specific walking training). Gait speed measures how long it takes a person to walk a short distance on a level surface, and it is often used as an indicator of functional mobility and health.
The findings highlight the importance of tailoring interventions:
Standard Program: This program is best suited for individuals with lower physical performance, such as slower gait speed or difficulty rising from a chair. Notably, participants with a strong perception of their physical abilities, as measured by the Late Life Function and Disability Index, showed the most significant improvements, suggesting that a positive self-assessment enhances engagement and benefits.
Plus Program: More effective for individuals with better baseline physical performance, including higher endurance and confidence in walking. Participants with sufficient strength and cardiovascular capacity gained the most from the task-specific skill training, improving neuromotor efficiency and gait speed.
The study also supports the idea of staged interventions. Focusing on building foundational strength and endurance before progressing to skill-based training could yield better results for those with limited physical performance.
While these findings are grounded in a high-quality randomized trial, the authors note limitations, including the reliance on gait speed as the sole outcome and challenges related to missing data. Nonetheless, the study underscores the potential to enhance resource efficiency in clinical settings by aligning interventions with individual needs, paving the way for more effective mobility rehabilitation for older adults.