Article

Traditional exercise programs for older adults, which focus on
aerobic and strength training, have had only modest effects on walking. Recently,
a motor learning exercise program was shown to have greater effects on walking
compared with a traditional exercise program.
Translating this novel motor
learning exercise program into a group exercise program would allow it to be
offered as an evidence-based, community-based program for older adults.
OBJECTIVE: To translate a walking rehabilitation program based on motor learning
theory from one-on-one to group delivery (On the Move) and evaluate multiple
aspects of implementation in older adults with impaired mobility. DESIGN: The
translation process involved multiple iterations, including meetings of experts
in the field (Phase I), focus groups (Phase II), and implementation of the newly
developed program (Phase III). Phase III was based on a one-group model of
intervention development for feasibility, safety, potential effects, and
acceptability. SETTING: Community sites, including 2 independent living
facilities, an apartment building, and a community center. PARTICIPANTS: Adults
65 years of age or older who could ambulate independently and who were medically
stable. Thirty-one adults, mean age 82.3 +/- 5.6 years, were eligible to
participate. METHODS: The group exercise program was held twice a week for 12
weeks. MAIN OUTCOME MEASUREMENTS: Acceptability of the program was determined by
retention and adherence rates and a satisfaction survey. Risk was measured by
adverse events and questions on perceived challenge and safety. Mobility was
assessed pre- and postintervention by gait speed, Figure of 8 Walk Test, and
6-minute walk test. RESULTS: Modifications to the program included adjustments to
format/length, music, education, and group interaction. The 12-week program was
completed by 24 of 31 entrants (77%). Adherence was high, with participants
attending on average 83% of the classes. Safety was excellent, with only 1
subject experiencing a controlled, noninjurious fall. There was preliminary
evidence for improved mobility after the intervention: gait speed improved from
0.76 +/- 0.21 to 0.81 +/- 0.22 m/s, P = .06; Figure of 8 Walk Test from 13.0 +/-
3.9 to 12.0 +/- 3.9 seconds, P = .07; and 6-minute walk test from 246 +/- 75 to
281 +/- 67 m, P = .02. CONCLUSIONS: The group-based program was safe and
acceptable to older adults with impaired mobility and resulted in potentially
clinically meaningful improvements in mobility.
CI - Copyright (c) 2016 American Academy of Physical Medicine and Rehabilitation.
Published by Elsevier Inc. All rights reserved.

Langue : ANGLAIS