Task Specific Timing and Coordination Exercises to Improve Mobility in Older Adults

描述（由申请人提供）：行走困难在老年人中很常见，而且费用很高。虽然传统的运动已被证明可以促进身心健康，并可能防止行走困难，但这种运动侧重于力量和耐力，而忽视了行走能力的一个关键组成部分;运动的时机和协调。衰老和疾病改变了时间和协调性，这反映在神经运动性能减慢、步态变异性增加和运动平稳性降低。任务特定的时间和协调运动，包括在多种步行条件下练习步态的平稳协调方面，具有比标准计划更大的改善步行能力的潜力。我们的初步数据表明，干预的时间和协调步态的影响流动性大于标准的力量和耐力计划。本建议的下一个关键步骤和目标是将两种干预措施联合收割机结合起来，以确定从标准加定时和协调计划中获得的机动性、活动和参与方面的潜在收益是否大于单独从标准计划中获得的收益。因此，拟议项目的主要目的是评估在标准力量和耐力训练中增加时机和协调训练对机动性的影响。次要目的包括检查1）代表干预成分和活动和参与措施的其他结果，2）干预的延迟和持续影响，以及3）干预在其他各种感兴趣的亚组中的影响。这项随机临床试验在老年人谁走得慢（即< 1.20米/秒）将比较372 社区居住的非干预性注意力控制和标准的12周的力量、耐力和灵活性计划到12周的力量、耐力、灵活性加上任务特定时间和协调训练的“标准+”计划。主要结局是12周时的步态速度。我们还将检查代表干预和活动和参与措施的组成部分的二级和三级结果，以及24周和36周的延迟和持续影响。这项疗效试验的结果将为任务特定时间和协调训练对提高步行能力的附加值提供证据 并将为未来的有效性试验奠定基础。未来的工作包括向非专业运动领导者进行翻译，其长期目标是将神经系统训练纳入标准运动计划中，以促进老年人的健康。

DESCRIPTION (provided by applicant): Walking difficulty is common and costly in older adults. While traditional exercise has been shown to promote physical and mental health and may prevent walking difficulty, such exercise has focused on strength and endurance, and has overlooked a critical component of walking ability; the timing and coordination of movement. Aging and disease alter timing and coordination as reflected by slowed neuromotor performance, increased gait variability and reduced smoothness of movement. Task specific timing and coordination exercise that includes practice of smooth coordinated aspects of gait over multiple walking conditions has the potential to improve walking ability greater than a standard program. Our preliminary data suggest that interventions on timing and coordination of gait impact mobility greater than the standard strength and endurance program. The next key step and the objective of this proposal is to combine the two interventions to determine if potential gains in mobility, activity and participation obtained from a standard plus timing and coordination program, are larger than the gains obtained from the standard program alone. Therefore, the primary aim of the proposed project is to evaluate the impact of adding timing and coordination training to standard strength and endurance training on mobility. Secondary aims include examining 1) additional outcomes representing the components of the intervention and measures of activity and participation, 2) the delayed and sustained effects of the intervention, and 3) the effects of the intervention within various other subgroups of interest. This randomized clinical trial in older adults who walk slowly (i.e. < 1.20 m/s) will compare a 372 community-dwelling non-intervention attention control and a standard 12 week strength, endurance and flexibility program to a 12 week "standard- plus" program of strength, endurance, flexibility plus task specific timing and coordination training. The primary outcome is gait speed at 12 weeks. We will also examine secondary and tertiary outcomes representing components of the intervention and measures of activity and participation and the delayed and sustained effects at 24 and 36 weeks. The findings from this efficacy trial will provide evidence for the added value of task specific timing and coordination training for promoting walking ability in older adults and will form the basis for future effectiveness trials. Future work includes translation to nonprofessional exercise leaders with the long-term goal to incorporate neurological training into standard exercise programs for health promotion for older adults.