Abstract / Summary
Background: Older adults with chronic joint pain often exhibit decreased mobility. Daily walking measures are being increasingly used in aging research as objective indicators of mobility.
Objective: In this study, we aimed to examine the effects of a 12-week hybrid exercise-based program on daily-life walking characteristics.
Methods: A total of 59 community-dwelling older adults (aged ≥65 years) with mild to moderate knee and/or low back pain were randomized to either a hybrid exercise group or an educational control group. Daily-life walking was monitored using an ankle sensor. Daily observation data were collected within 2 planned 7-day windows. Primary parameters included activity volume and gait characteristics. Statistical analyses were conducted based on a modified intention-to-treat principle using linear mixed-effects models, with a per-protocol set used for sensitivity analyses.
Results: The mixed-effects analysis based on the modified intention-to-treat principle (n=52 participants; 696 observations) suggested an effect of the intervention on improving walking quality, particularly step length (β=2.39 cm; P=.04; Hedges g=0.493), with a smaller effect with borderline statistical significance observed on improving walking speed (β=0.05 m/s; P=.06; Hedges g=0.496). Cadence, daily distance, daily steps, active energy expenditure, and accumulated 3 or more metabolic equivalent of task activities showed no clear difference between the groups. In the per-protocol sensitivity analysis (n=44), the same directional pattern of improvement was observed for step length (β=1.95 cm; P=.13; Hedges g=0.365) and walking speed (β=0.04 m/s; P=.14; Hedges g=0.368); however, the estimates were imprecise.
Conclusions: A 12-week hybrid exercise program may improve the quality of daily-life walking, with the clearest effect observed on step length. Given the attenuation after multiplicity-aware interpretation and in sensitivity analyses, these findings should be interpreted as suggestive rather than definitive.