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Should physical activity programs be tailored when older adults have compromised function?
Marsh AP, Chmelo EA, Katula JA, Mihalko SL, Jack Rejeski W
Journal of Aging and Physical Activity 2009 Jul;17(3):294-306
clinical trial
5/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

The purpose of this study was to determine whether a walking program supplemented by tasks designed to challenge balance and mobility (WALK+) could improve physical function more than a traditional walking program (WALK) in older adults at risk for mobility disability. 31 community-dwelling older adults (mean +/- SD age 76 +/- 5 yr; Short Physical Performance Battery (SPPB) score = 8.4 +/- 1.7) were randomized to treatment. Both interventions were 18 sessions (1 hr, 3x/wk) and progressive in intensity and duration. Physical function was assessed using the SPPB and the 400-m-walk time. A subset of participants in the WALK group who had relatively lower baseline function showed only small improvement in their SPPB scores after the intervention (0.3 +/- 0.5), whereas a subset of participants in the WALK+ group with low baseline function showed substantial improvement in their SPPB scores (2.2 +/- 0.7). These preliminary data underscore the potential importance of tailoring interventions for older adults based on baseline levels of physical function.

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