Effect of Therapeutic Exercise on Gait Speed in Community-Dwelling Elderly People: A Meta-analysis

Abstract

Background and Purpose. Inconsistent research findings make it unclear whether therapeutic exercise improves gait speed in community-dwelling elderly people. Using meta-analytical procedures, we examined the effect of therapeutic exercise on changing gait speed in community-dwelling older adults and the effect of type, intensity, and dose of therapeutic exercise on gait speed. Method. Studies were retrieved using a comprehensive database search. Two independent reviewers determined study eligibility based on inclusion criteria, rated study quality, and extracted information on study methods, design, intervention, and results. Data were combined to obtain an overall effect size, its 95% confidence interval, and a measure of significance. In addition, analyses to characterize the clinical relevance of the findings were performed. Results. One hundred seventeen studies were evaluated, with 24 studies (n=1,302 subjects) meeting the inclusion criteria for habitual gait speed and 18 studies (n=752 subjects) meeting the inclusion criteria for fast gait speed. Therapeutic exercise—or, more specifically, strength training and combination training (aerobic plus other exercise)—had significant effects (r=.145, P=.017; r=.176, P=.002, respectively) on habitual gait speed. High-intensity (effort expended by subjects) exercise and high-dosage (frequency and duration of exercise sessions) intervention also had a significant effect (r=.184, P=.001; r=.190, P=.001, respectively) on gait speed, whereas there was no effect for moderate- and low-intensity exercise or for low-dosage exercise. No exercise intervention affected fast gait speed in this analysis. Discussion and Conclusion. The results provide support for the belief that therapeutic exercise can improve gait speed in community-dwelling elderly people and that intensity and dosage are important contributing factors. The relatively weak correlation found between therapeutic exercise and gait speed merits further study. [Lopopolo RB, Greco M, Sullivan DH, et al. Effect of therapeutic exercise on gait speed in community-dwelling elderly people: a meta-analysis. Phys Ther. 2006;86:520–540.]

Global brain atrophy is associated with physical performance and the risk of falls in older adults with cognitive impairment

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Complex obstacle negotiation exercise can prevent falls in community‐dwelling elderly Japanese aged 75 years and older

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Testing the Senior Exercise Self‐efficacy Project (SESEP) for Use with Urban Dwelling Minority Older Adults

“…Physical activity for all racial, ethnic, age, and gender groups has been shown to reduce the risk of cardiovascular disease, particularly stroke (Goldstein et al, 2006;Sacco et al, 2006). In addition, metaanalytic reviews have provided strong evidence that participation in either nonspecific physical activity or specific aerobic or resistive activities is associated with a variety of health improvements, such as: decreased risk of coronary heart disease and stroke (Cornelissen & Fagard, 2005;Lee, Folsom, & Blair, 2003;Wendel-Vos et al, 2004); decreased progression of degenerative joint disease (Roddy et al, 2005); prevention of osteoporosis of the lumbar spine (Palombaro, 2005); decreased incidence of falls (Chang et al, 2004;Weatherall, 1994); increased gait speed if the activity is of sufficient intensity and dosage (Lopopolo, Greco, Sullivan, Craik, & Mangione, 2006); improved cognitive function in sedentary older adults (Colcombe & Kramer, 2003) and in those with dementia (Heyn, Abren, & Ottenbacher, 2004); a modest benefit in quality of life for frail older adults (Schechtman & Ory, 2001); and a positive association with successful aging (Depp & Jeste, 2006).…”