Live Long Walk Strong (LLWS) Rehabilitation Program: What Features Improve Mobility Skills

VA Office of Research and Development

Status: Completed

Conditions: Mobility Limitation

Treatments: Other: Live Long Walk Strong rehabilitation program

Study type: Interventional

Funder types: Other U.S. Federal agency

Identifiers

NCT04026503

E3095-R

Details and patient eligibility

About

This study was performed to evaluate the efficacy of the Live Long Walk Strong rehabilitation program in Veterans 50 years and older. This study will examine the features of the program that contribute to improved gait speed.

Full description

This study was a 4 year phase II randomized clinical trial study design. This study will provide important information about the mechanisms that contribute to meaningful improvement in mobility, the benefits of a novel mode of physical therapy care, and the duration of treatment effect.

This study addresses Veterans with slow gait speed beginning in midlife. Slow walking speed is a major health concern for aging Veterans, that independent of disease status, predicts adverse health outcomes. Physical therapy (PT) care is the foundational treatment for slow gait speed, but no standard treatment approach exists. Clinically feasible modes of PT care that provide longer term improvements in gait speed are not established. The investigators developed Live Long Walk Strong , which is a clinically feasible program of PT care that builds upon research identifying novel modes of treatment with greater efficacy than standard care. The investigators have shown proof of concept among civilians and must confirm this among Veterans across a broader age range than was studied previously. Also, it is critical that the investigators define the attributes targeted by which LLWS induces gait speed improvements, not only after treatment ends but after 16 weeks of subsequent follow up. If successful, it will lead to LLWS refinements, establishing it as a rigorously tested model of PT care, that can be implemented across the VHA nationally.

Enrollment: 151 patients

Sex: All

Ages: 50+ years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Veteran
• Aged 50 and older
• Community dwelling
• Ability to speak and understand English
• Usual gait speed 0.5 m/s- 1.0 m/s Activity modifications and access to telehealth rehabilitation

Exclusion criteria

• Presence of a terminal disease

• A major medical problem, unstable chronic condition, or psychiatric disorder that interferes with safe and successful testing and training

• Myocardial infarction or major surgery in previous 3 months

• Planned major surgery

• Baseline short physical performance battery score less than 4

• Use of a walker

• Modified mini mental status examination score less than or equal to 77

• Presence of a significant disease specific impairment such as:

  • peripheral neurologic impairment
  • orthopedic impairment
  • visual impairment

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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151 participants in 2 patient groups

Live Long Walk Strong

Experimental group

Description:

8 week rehabilitation program

Treatment:

Other: Live Long Walk Strong rehabilitation program

8 week wait list control

Active Comparator group

Description:

8 week wait list then followed by 8 weeks of the Live Long Walk Strong rehabilitation program

Treatment:

Other: Live Long Walk Strong rehabilitation program