Evaluating the Feasibility and Effects of a Short-term Task Specific Power Training with and without Cognitive Training among Older Adults with Slow Gait Speed: A Pilot Study

Abstract Objectives To investigate the feasibility and efficacy of short-term functional power training and further examine whether the addition of cognitive training targeting sustained attention and inhibitory control would augment the impact on the outcomes. Design Randomized pilot study. Setting Clinical research facility. Participants Community-dwelling primary care patients with mobility limitation within the VA Boston Healthcare System age ≥65 years. Interventions Participants were randomly assigned to either functional power training (n=14) or functional power+cognitive training (n=11), offered 3 times weekly for 6 weeks. Session durations were either 70 minutes (functional power+cognitive training) or 40 minutes (functional power training). Main Outcome Measures Feasibility (dropouts, attendance), mobility performance (Short Physical Performance Battery (SPPB)), leg power (stair climb test), dynamic balance (figure-of-8), and gait characteristics (gait speed, stance time, step width, swing time, step length, and variabilities under single-task and dual-task conditions) were evaluated. Nonparametric analyses were used to compare overall pre-post changes and between-group differences. Results Of the 39 Veterans screened, 25 were randomized and enrolled. Twenty-one men with mean age 76±7 years completed the study and 86% were white. Participants had a mean SPPB score of 8.3±1.6 out of 12. For those completing the study, overall attendance was 79%. Among all participants, clinically relevant and/or statistically significant median change in mobility performance (∆1 point), leg power (∆25.0W), dynamic balance (∆-1.1s), and gait characteristics (gait speed (∆0.08s, ∆0.09s), step length (∆1.9cm, ∆3.8cm), and stance time (∆-0.02s, ∆-0.05s) under single-task and dual-task, respectively) were observed after 6-week training. There were no statistically significant group differences among dropouts, attendance rate, or any of the outcomes based on cognitive training status. Conclusions Short-term functional power training with or without a cognitive training led to clinically meaningful improvements in mobility performance, leg power, dynamic balance, and gait characteristics. These findings add to the body of evidence supporting the benefits of functional power training on clinically relevant outcomes. Additional cognitive training did not have an added effect on the study outcomes from our study and further research is needed.