The Live Long Walk Strong Rehabilitation Program Study: Design and Methods

OBJECTIVE: To identify attributes targeted by rehabilitative treatment within which improvements lead to short- and long-term changes in mobility. Maintaining independence in mobility is important to many older adults and is associated with critical outcomes such as aging in place, morbidity, and mortality. DESIGN: The Live Long Walk Strong rehabilitation study is a phase 2 single-blind, randomized controlled trial. SETTING: Veterans Affairs Boston Healthcare System, outpatient physical therapy. PARTICIPANTS: 198 community-dwelling middle- and older-aged veterans (aged 50 years and older) will be recruited from primary care practices (N=198). INTERVENTIONS: Comparing a moderate-vigorous intensity physical therapy program of 10 sessions with a waitlist control group. MAIN OUTCOME MEASURE: The primary outcome measure is gait speed. Secondary outcomes include leg strength and power, trunk muscle endurance, gait smoothness, and exercise self-efficacy. RESULTS: Outcomes will be assessed within 2 weeks of intervention completion, at 8 weeks postintervention, and at 16 weeks postintervention. Two-sample t tests will compare mean change in gait speed and target attributes (leg power, trunk muscle endurance, gait smoothness, and exercise self-efficacy) between treatment and control groups. Paired t tests will examine within-person change at subsequent follow-up visits. Multivariable regression analyses will evaluate relationships between dependent and independent variables and potential mediation adjusting for relevant covariates. CONCLUSIONS: Results of this study are expected to advance and refine the design of Live Long Walk Strong rehabilitative care and demonstrate its proof of concept and efficacy.