Effects of Three Types of Exercise Interventions on Healthy Old Adults’ Gait Speed: A Systematic Review and Meta-Analysis

Abstract

BackgroundHabitual walking speed predicts many clinical conditions later in life, but it declines with age. However, which particular exercise intervention can minimize the age-related gait speed loss is unclear.PurposeOur objective was to determine the effects of strength, power, coordination, and multimodal exercise training on healthy old adults’ habitual and fast gait speed.MethodsWe performed a computerized systematic literature search in PubMed and Web of Knowledge from January 1984 up to December 2014. Search terms included ‘Resistance training’, ‘power training’, ‘coordination training’, ‘multimodal training’, and ‘gait speed (outcome term). Inclusion criteria were articles available in full text, publication period over past 30 years, human species, journal articles, clinical trials, randomized controlled trials, English as publication language, and subject age ≥65 years. The methodological quality of all eligible intervention studies was assessed using the Physiotherapy Evidence Database (PEDro) scale. We computed weighted average standardized mean differences of the intervention-induced adaptations in gait speed using a random-effects model and tested for overall and individual intervention effects relative to no-exercise controls.ResultsA total of 42 studies (mean PEDro score of 5.0 ± 1.2) were included in the analyses (2495 healthy old adults; age 74.2 years [64.4–82.7]; body mass 69.9 ± 4.9 kg, height 1.64 ± 0.05 m, body mass index 26.4 ± 1.9 kg/m2, and gait speed 1.22 ± 0.18 m/s). The search identified only one power training study, therefore the subsequent analyses focused only on the effects of resistance, coordination, and multimodal training on gait speed. The three types of intervention improved gait speed in the three experimental groups combined (n = 1297) by 0.10 m/s (±0.12) or 8.4 % (±9.7), with a large effect size (ES) of 0.84. Resistance (24 studies; n = 613; 0.11 m/s; 9.3 %; ES: 0.84), coordination (eight studies, n = 198; 0.09 m/s; 7.6 %; ES: 0.76), and multimodal training (19 studies; n = 486; 0.09 m/s; 8.4 %, ES: 0.86) increased gait speed statistically and similarly.ConclusionsCommonly used exercise interventions can functionally and clinically increase habitual and fast gait speed and help slow the loss of gait speed or delay its onset.Electronic supplementary materialThe online version of this article (doi:10.1007/s40279-015-0371-2) contains supplementary material, which is available to authorized users.

The Impact of Pilates Exercises on Motor Control of Inactive Middle-Aged Women

“…By combining the body concentration and maintaining the proper body alignment, principle of Pilates stretch helps to stretch muscles in the complete range of motion needed for the muscle balance, and at the same time the contraction, that is done with the body support. Improvement of balance condition and walking speed was consistent with the results of Iwamoto et al (2009), but it contradicted by part of the results of a study which concluded that land endurance exercises did not have a significant effect on the walking speed (Hortobágyi et al, 2015). Although the nature of the training program used in the research is similar, the difference in the outcomes could be resulted from ignoring some factors such as the level of readiness of testers, physical activity level, motivation, gender, age, height, weight.…”

Non-Discriminant Relationships between Leg Muscle Strength, Mass and Gait Performance in Healthy Young and Old Adults

“…Because of the diminished and increased contribution, respectively, by the ankle plantarflexors and hip extensors to the total mechanical output during gait [11] , we expect to find different correlations between gait speed and ankle plantarflexor (low correlation) versus hip extensor (high correlations) maximal voluntary torques in old adults. Such an expectation contrasts with the prevailing data that focused on the relationship between mobility and knee extensor function [10,14] even though old age has virtually no effects on knee kinetics measured during gait [10,11] .…”

“…Our old adults' 1.5 m/s habitual gait speed is at the high end of habitual gait speed norms of 1.15 [26] , 1.24 [14] , and 1.30 m/s [27] as is the 2.0 m/s maximal gait speed (normal range: 1.44-1.99 m/s). Still, relative to the reference young adults group, old adults walked ∼ 12% slower with ∼ 11% shorter steps, had 18% lower leg LTM and were 34% weaker (all p < 0.05, Table 2 ).…”

“…2 b). While the age-related loss of leg power can exceed that of leg strength [34] , curiously the force compared with the velocity component of mechanical power generation by leg muscles is substantially higher in old adults [35] , assigning a putative role of leg muscle strength in power generation, making it a valid correlate of gait speed, and a target for interventions [14] . Together, in physically highly active healthy old adults, leg muscle strength and leg LTM weakly and similarly correlated with gait performance, favoring neither outcome for predicting mobility.…”

Effectiveness of a Timing and Coordination Group Exercise Program to Improve Mobility in Community-Dwelling Older Adults

“…2,3 Exercise is beneficial to physical and mental health and may prevent walking difficulty. [4][5][6] Communitybased group exercise programs are 1 option for promoting health and wellness and could potentially be used to improve walking in older adults. Studies examining the impact of group exercise prog r a m s o n w a l k i ng h a ve c o n f l i c t i ng f i n d i ng s a n d limitations.…”