Preclinical mobility limitations (PCML) manifest early in the process of declining mobility, and are not typically identified or acted upon by clinicians. These mobility limitations manifest as changes in how daily tasks such as walking are performed (slower speed, lower endurance). Persons in the PCML stage are at increased risk for the onset of disability and chronic disease. Persistent deterioration in mobility is a predictor of mortality and has been reported even in the absence of changes in activities of daily living over a two-year period. Further, older persons with mobility limitations, including reduced gait speed, are at risk for falls. These cumulative transitions of a person's life-long mobility form their mobility trajectory and preventing mobility decline at an early stage along this trajectory is the focus of this research initiative. This study will evaluate a novel intervention, STEPPING-UP, for improving walking ability in persons with PCML.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
SINGLE
Enrollment
249
The intervention group will receive STEPPING-UP, a virtual 12-week, multicomponent intervention that includes tailored task-oriented motor learning exercise and a mobility self-management (SM) program.
The participants assigned to this group will receive a 12-week Telephone-Based Coaching Walking Program (TELE) delivered by a PT who will help participants set short and long term walking goals.
Participants assigned to this group will receive a virtual 12-week Chair-Based Yoga Program (YOGA), a group-based exercise control where participants will undertake a seated exercise program that includes: warm up, seated and standing yoga poses, cool down.
McMaster University
Hamilton, Ontario, Canada
Walking speed
The 4-Metre Gait Speed Test (4MGS) is a performance-based measure of walking speed. The 4MGS test will be performed from a standing start at both a self-selected (usual) and fastest walking speed.
Time frame: Baseline
Change in walking speed from baseline
The 4-Metre Gait Speed Test (4MGS) is a performance-based measure of walking speed. The 4MGS test will be performed from a standing start at both a self-selected (usual) and fastest walking speed.
Time frame: 12 weeks
Change in walking speed from baseline
The 4-Metre Gait Speed Test (4MGS) is a performance-based measure of walking speed. The 4MGS test will be performed from a standing start at both a self-selected (usual) and fastest walking speed.
Time frame: 24 weeks
Change in walking speed from baseline
The 4-Metre Gait Speed Test (4MGS) is a performance-based measure of walking speed. The 4MGS test will be performed from a standing start at both a self-selected (usual) and fastest walking speed.
Time frame: 36 weeks
Exercise capacity
2-Minute Step Test (TMST): The TMST is a test of exercise capacity that can be used as an alternative to a timed long-distance walking test when assessment space is limited. Individuals are required to march in place as quickly as possible for 2 minutes while lifting their knees to a height midway between their patella and iliac crest when standing.
Time frame: Baseline
Change in exercise capacity from baseline
2-Minute Step Test (TMST): The TMST is a test of exercise capacity that can be used as an alternative to a timed long-distance walking test when assessment space is limited. Individuals are required to march in place as quickly as possible for 2 minutes while lifting their knees to a height midway between their patella and iliac crest when standing.
Time frame: 12 weeks
Change in exercise capacity from baseline
2-Minute Step Test (TMST): The TMST is a test of exercise capacity that can be used as an alternative to a timed long-distance walking test when assessment space is limited. Individuals are required to march in place as quickly as possible for 2 minutes while lifting their knees to a height midway between their patella and iliac crest when standing.
Time frame: 24 weeks
Change in exercise capacity from baseline
2-Minute Step Test (TMST): The TMST is a test of exercise capacity that can be used as an alternative to a timed long-distance walking test when assessment space is limited. Individuals are required to march in place as quickly as possible for 2 minutes while lifting their knees to a height midway between their patella and iliac crest when standing.
Time frame: 36 weeks
Lower body strength
30-Second Chair Stand Test (CST): The 30-Second CST is used to assess lower body strength and power and is measured by the number of chair stand repetitions in a 30-second period.
Time frame: Baseline
Change in lower body strength from baseline
30-Second Chair Stand Test (CST): The 30-Second CST is used to assess lower body strength and power and is measured by the number of chair stand repetitions in a 30-second period.
Time frame: 12 weeks
Change in lower body strength from baseline
30-Second Chair Stand Test (CST): The 30-Second CST is used to assess lower body strength and power and is measured by the number of chair stand repetitions in a 30-second period.
Time frame: 24 weeks
Change in lower body strength from baseline
30-Second Chair Stand Test (CST): The 30-Second CST is used to assess lower body strength and power and is measured by the number of chair stand repetitions in a 30-second period.
Time frame: 36 weeks
Dual task cost
Difference in time between the Timed Up and Go (TUG) and the TUG Cognitive.
Time frame: Baseline
Change in dual task cost from baseline
Difference in time between the Timed Up and Go (TUG) and the TUG Cognitive.
Time frame: 12 weeks
Change in dual task cost from baseline
Difference in time between the Timed Up and Go (TUG) and the TUG Cognitive.
Time frame: 24 weeks
Change in dual task cost from baseline
Difference in time between the Timed Up and Go (TUG) and the TUG Cognitive.
Time frame: 36 weeks
Self-reported change in mobility
Global Mobility Change Rating: A single question, ''Since your last visit, has there been any change in your mobility?'' will be asked. The response will be made on a 11-point self-reported Likert scale: - 5 = very much worse; 0 = unchanged; 5 = very much better.
Time frame: 12 weeks
Change in self-reported change in mobility from basseline
Global Mobility Change Rating: A single question, ''Since your last visit, has there been any change in your mobility?'' will be asked. The response will be made on a 11-point self-reported Likert scale: - 5 = very much worse; 0 = unchanged; 5 = very much better.
Time frame: 24 weeks
Change in self-reported change in mobility from basseline
Global Mobility Change Rating: A single question, ''Since your last visit, has there been any change in your mobility?'' will be asked. The response will be made on a 11-point self-reported Likert scale: - 5 = very much worse; 0 = unchanged; 5 = very much better.
Time frame: 36 weeks
Balance self-efficacy
Activities-specific Balance Confidence (ABC) Scale: The ABC Scale is a self-report measure of balance confidence. Individuals are asked to rate their confidence in completing 16 common tasks without losing balance, on a scale from 0% (no confidence) to 100% (complete confidence).
Time frame: Baseline
Change in balance self-efficacy from baseline
Activities-specific Balance Confidence (ABC) Scale: The ABC Scale is a self-report measure of balance confidence. Individuals are asked to rate their confidence in completing 16 common tasks without losing balance, on a scale from 0% (no confidence) to 100% (complete confidence).
Time frame: 12 weeks
Change in balance self-efficacy from baseline
Activities-specific Balance Confidence (ABC) Scale: The ABC Scale is a self-report measure of balance confidence. Individuals are asked to rate their confidence in completing 16 common tasks without losing balance, on a scale from 0% (no confidence) to 100% (complete confidence).
Time frame: 24 weeks
Change in balance self-efficacy from baseline
Activities-specific Balance Confidence (ABC) Scale: The ABC Scale is a self-report measure of balance confidence. Individuals are asked to rate their confidence in completing 16 common tasks without losing balance, on a scale from 0% (no confidence) to 100% (complete confidence).
Time frame: 36 weeks
Mobility patterns
The Life-Space Assessment (LSA): The LSA measures a person's usual pattern of mobility during a 1-month period, documenting mobility based on how far and how often a person travels and any assistance required.
Time frame: Baseline
Change in mobility patterns from baseline
The Life-Space Assessment (LSA): The LSA measures a person's usual pattern of mobility during a 1-month period, documenting mobility based on how far and how often a person travels and any assistance required.
Time frame: 12 weeks
Change in mobility patterns from baseline
The Life-Space Assessment (LSA): The LSA measures a person's usual pattern of mobility during a 1-month period, documenting mobility based on how far and how often a person travels and any assistance required.
Time frame: 24 weeks
Change in mobility patterns from baseline
The Life-Space Assessment (LSA): The LSA measures a person's usual pattern of mobility during a 1-month period, documenting mobility based on how far and how often a person travels and any assistance required.
Time frame: 36 weeks
Knowledge, skill and confidence for self-management
Patient Activation Measure (PAM): The PAM is a 13-item measure of the patient's level of knowledge, skill and confidence for SM. An Activation Score is calculated as the sum of the 13 items. The Activation Score can then be converted into an Activation Level (Level 1 = low activation, Level 4 = high activation).
Time frame: 12 weeks
Change in knowledge, skill and confidence for self-management from baseline
Patient Activation Measure (PAM): The PAM is a 13-item measure of the patient's level of knowledge, skill and confidence for SM. An Activation Score is calculated as the sum of the 13 items. The Activation Score can then be converted into an Activation Level (Level 1 = low activation, Level 4 = high activation).
Time frame: Baseline
Change in knowledge, skill and confidence for self-management from baseline
Patient Activation Measure (PAM): The PAM is a 13-item measure of the patient's level of knowledge, skill and confidence for SM. An Activation Score is calculated as the sum of the 13 items. The Activation Score can then be converted into an Activation Level (Level 1 = low activation, Level 4 = high activation).
Time frame: 24 weeks
Change in knowledge, skill and confidence for self-management from baseline
Patient Activation Measure (PAM): The PAM is a 13-item measure of the patient's level of knowledge, skill and confidence for SM. An Activation Score is calculated as the sum of the 13 items. The Activation Score can then be converted into an Activation Level (Level 1 = low activation, Level 4 = high activation).
Time frame: 36 weeks
Balance
Unipedal Stance Test (UPST): The UPST is used to assess static balance. 68 Individuals are asked to stand barefoot on the limb of their choice until they (1) use their arms (i.e., uncross arms), (2) use their raised foot (i.e., move it toward or away from the standing limb or touched the floor), (3) move the weight-bearing foot to maintain their balance (i.e., rotate foot on the ground) or (4) maintain the position for a maximum of 45 seconds.
Time frame: Baseline
Change in balance from baseline
Unipedal Stance Test (UPST): The UPST is used to assess static balance. 68 Individuals are asked to stand barefoot on the limb of their choice until they (1) use their arms (i.e., uncross arms), (2) use their raised foot (i.e., move it toward or away from the standing limb or touched the floor), (3) move the weight-bearing foot to maintain their balance (i.e., rotate foot on the ground) or (4) maintain the position for a maximum of 45 seconds.
Time frame: 12 weeks
Change in balance from baseline
Unipedal Stance Test (UPST): The UPST is used to assess static balance. 68 Individuals are asked to stand barefoot on the limb of their choice until they (1) use their arms (i.e., uncross arms), (2) use their raised foot (i.e., move it toward or away from the standing limb or touched the floor), (3) move the weight-bearing foot to maintain their balance (i.e., rotate foot on the ground) or (4) maintain the position for a maximum of 45 seconds.
Time frame: 24 weeks
Change in balance from baseline
Unipedal Stance Test (UPST): The UPST is used to assess static balance. 68 Individuals are asked to stand barefoot on the limb of their choice until they (1) use their arms (i.e., uncross arms), (2) use their raised foot (i.e., move it toward or away from the standing limb or touched the floor), (3) move the weight-bearing foot to maintain their balance (i.e., rotate foot on the ground) or (4) maintain the position for a maximum of 45 seconds.
Time frame: 36 weeks
Health-related quality of life
EQ-5D-5L is a generic utility-based health related quality of life questionnaire. Respondents are asked to rate 5 dimensions of their health: mobility, self-care, usual activities, pain/discomfort and anxiety/depression. The five response levels are:no problems (1), slight problems (2), moderate problems (3), severe problems (4), unable to /extreme problems (5).
Time frame: Baseline
Change in health-related quality of life from baseline
EQ-5D-5L is a generic utility-based health related quality of life questionnaire. Respondents are asked to rate 5 dimensions of their health: mobility, self-care, usual activities, pain/discomfort and anxiety/depression. The five response levels are:no problems (1), slight problems (2), moderate problems (3), severe problems (4), unable to /extreme problems (5).
Time frame: 12 weeks
Change in health-related quality of life from baseline
EQ-5D-5L is a generic utility-based health related quality of life questionnaire. Respondents are asked to rate 5 dimensions of their health: mobility, self-care, usual activities, pain/discomfort and anxiety/depression. The five response levels are:no problems (1), slight problems (2), moderate problems (3), severe problems (4), unable to /extreme problems (5).
Time frame: 24 weeks
Change in health-related quality of life from baseline
EQ-5D-5L is a generic utility-based health related quality of life questionnaire. Respondents are asked to rate 5 dimensions of their health: mobility, self-care, usual activities, pain/discomfort and anxiety/depression. The five response levels are:no problems (1), slight problems (2), moderate problems (3), severe problems (4), unable to /extreme problems (5).
Time frame: 36 weeks
Self-efficacy for physical activity:
Participants will be asked to rate how confident they are that they could participate in moderate intensity physical activity for 150 minutes per week using a single question on a scale of 1-10. Higher values indicate greater self-efficacy.
Time frame: Baseline
Change in self-efficacy for physical activity from baseline
Participants will be asked to rate how confident they are that they could participate in moderate intensity physical activity for 150 minutes per week using a single question on a scale of 1-10. Higher values indicate greater self-efficacy.
Time frame: 12 weeks
Change in self-efficacy for physical activity from baseline
Participants will be asked to rate how confident they are that they could participate in moderate intensity physical activity for 150 minutes per week using a single question on a scale of 1-10. Higher values indicate greater self-efficacy.
Time frame: 24 weeks
Change in self-efficacy for physical activity from baseline
Participants will be asked to rate how confident they are that they could participate in moderate intensity physical activity for 150 minutes per week using a single question on a scale of 1-10. Higher values indicate greater self-efficacy.
Time frame: 36 weeks
Self-reported mobility
Mobility Assessment Tool (MAT-sf): The MAT-sf is a video-animated tool for assessing mobility. It consists of 10 animated video clips that assess an individuals' perceived level of proficiency in performing each task.
Time frame: Baseline
Change in self-reported mobility from baseline
Mobility Assessment Tool (MAT-sf): The MAT-sf is a video-animated tool for assessing mobility. It consists of 10 animated video clips that assess an individuals' perceived level of proficiency in performing each task.
Time frame: 12 weeks
Change in self-reported mobility from baseline
Mobility Assessment Tool (MAT-sf): The MAT-sf is a video-animated tool for assessing mobility. It consists of 10 animated video clips that assess an individuals' perceived level of proficiency in performing each task.
Time frame: 24 weeks
Change in self-reported mobility from baseline
Mobility Assessment Tool (MAT-sf): The MAT-sf is a video-animated tool for assessing mobility. It consists of 10 animated video clips that assess an individuals' perceived level of proficiency in performing each task.
Time frame: 36 weeks
Emergency room visits
Healthcare utilization data collected using self-report self-report.
Time frame: Baseline to 12 weeks
Emergency room visits
Healthcare utilization data collected using self-report self-report.
Time frame: 12 weeks to 24 weeks
Emergency room visits
Healthcare utilization data collected using self-report self-report.
Time frame: 24 weeks to 36 weeks
Hospitalizations
Healthcare utilization data collected using self-report self-report.
Time frame: Baseline to 12 weeks
Hospitalizations
Healthcare utilization data collected using self-report self-report.
Time frame: 12 weeks to 24 weeks
Hospitalizations
Healthcare utilization data collected using self-report self-report.
Time frame: 24 weeks to 36 weeks
Family doctor visits
Healthcare utilization data collected using self-report self-report.
Time frame: Baseline to 12 weeks
Family doctor visits
Healthcare utilization data collected using self-report self-report.
Time frame: 12 weeks to 24 weeks
Family doctor visits
Healthcare utilization data collected using self-report self-report.
Time frame: 24 weeks to 36 weeks
Specialist physician visits visits
Healthcare utilization data collected using self-report self-report.
Time frame: Baseline to 12 weeks
Specialist physician visits visits
Healthcare utilization data collected using self-report self-report.
Time frame: 12 weeks to 24 weeks
Specialist physician visits visits
Healthcare utilization data collected using self-report self-report.
Time frame: 24 weeks to 36 weeks
Medical tests or procedures
Healthcare utilization data collected using self-report self-report.
Time frame: Baseline to 12 weeks
Medical tests or procedures
Healthcare utilization data collected using self-report self-report.
Time frame: 12 weeks to 24 weeks
Medical tests or procedures
Healthcare utilization data collected using self-report self-report.
Time frame: 24 weeks to 36 weeks
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.