Richardson Julie, Kuspinar Ayse, Sinclair Susanne, Beauchamp Marla, Dufour Sinead, Tang Ada, MacDermid Joy, Durocher Evelyne, Thabane Lehana, Xie Feng, Costa Andrew
School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada.
McMaster Institute for Research on Aging (MIRA), McMaster University, Hamilton, ON, Canada.
JMIR Res Protoc. 2025 May 21;14:e72585. doi: 10.2196/72585.
Walking difficulties are a common and costly problem. However, disability associated with the decline in walking ability is not an inevitable consequence. With an aging population, it is increasingly important to establish strategies to help older adults preserve the capacity to live independently and function well in late life. Preclinical mobility limitation (PCML), which is characterized by subtle changes or limitations in mobility that precede disability, manifests as changes in how daily tasks such as walking are performed. Persons with PCML are at increased risk for the onset of disability and chronic disease. For that reason, PCML is a critical stage in the natural history of functional change when there is the opportunity for primary prevention interventions.
To evaluate the effect of a 12-week online mobility self-management program (Stepping Up) on mobility outcomes, including walking speed, aerobic exercise capacity, dual-task cost, physical functioning (balance and strength), balance confidence, extent of community mobility, self-management of mobility, and quality of life in older adults with PCML.
This randomized controlled trial (RCT) will recruit 249 older adults (aged 55-75 years) screened for PCML. Participants will be assigned to the Stepping Up program, a telephone-based coaching walking program or an online chair-based yoga program. Programs will be delivered over 12 weeks and participants will undergo virtual assessments with a blinded physiotherapist at baseline, 12, 24, and 36 weeks. An economic evaluation will be conducted alongside this RCT.
A total of 253 participants were enrolled in the trial. Data collection commenced in August 2021 and will be completed in October 2025. Data analysis will begin in November 2025 and results will be published in the Summer of 2026.
To our knowledge, PCML has not been addressed by primary prevention interventions that incorporate both task-oriented motor learning exercise and mobility self-management sessions. Results will establish if the Stepping-Up program has the potential to serve as a model for sustainable, accessible, and cost-effective programming for individuals with early mobility limitations.
ClinicalTrials.gov NCT04368949; https://clinicaltrials.gov/study/NCT04368949.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/72585.
行走困难是一个常见且代价高昂的问题。然而，与行走能力下降相关的残疾并非不可避免的后果。随着人口老龄化，制定策略以帮助老年人保持独立生活能力并在晚年良好地发挥功能变得越来越重要。临床前活动受限（PCML），其特征是在残疾之前活动出现细微变化或受限，表现为诸如行走等日常任务执行方式的改变。患有PCML的人发生残疾和慢性病的风险增加。因此，PCML是功能变化自然史中的一个关键阶段，此时有机会进行一级预防干预。
评估为期12周的在线活动自我管理计划（“奋起行动”）对患有PCML的老年人的活动结果的影响，包括步行速度、有氧运动能力、双重任务成本、身体功能（平衡和力量）、平衡信心、社区活动范围、活动自我管理以及生活质量。
这项随机对照试验（RCT）将招募249名经筛查患有PCML的老年人（年龄在55 - 75岁之间）。参与者将被分配到“奋起行动”计划、基于电话辅导的步行计划或在线椅子瑜伽计划。这些计划将在12周内实施，参与者将在基线、第12、24和36周接受由 blinded 物理治疗师进行的虚拟评估。将在此RCT的同时进行一项经济评估。
共有253名参与者被纳入试验。数据收集于[此处原文有误，推测为2021年8月]开始，并将于2025年10月完成。数据分析将于2025年11月开始，结果将于2026年夏季发表。
据我们所知，纳入以任务为导向的运动学习练习和活动自我管理课程的一级预防干预措施尚未解决PCML问题。结果将确定“奋起行动”计划是否有可能成为为早期活动受限个体提供可持续、可及且具有成本效益的计划的典范。
ClinicalTrials.gov NCT04368949；https://clinicaltrials.gov/study/NCT04368949。
国际注册报告标识符（IRRID）：DERR1-10.2196/72585。
