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Research Reports |
RB Lopopolo, PT, PhD, MBA, is Professor, Department of Physical Therapy, Arcadia University, Glenside, Pa
M Greco, PT, DPT, is a Staff Therapist at Hazleton General Hospital, Hazleton, Pa. She was completing her DPT studies at Arcadia University at the time of the study
DH Sullivan, PT, DPT, is a Staff Therapist at Nazareth Hospital, Philadelphia Pa. She was completing her DPT studies at Arcadia University at the time of the study
RL Craik, PT, PhD, FAPTA, is Professor and Chair, Department of Physical Therapy, Arcadia University, 450 S Easton Rd, Glenside, PA 19038-3295 (USA)
KK Mangione, PT, PhD, GCS, is Associate Professor, Department of Physical Therapy, Arcadia University
(craik{at}arcadia.edu). Address all correspondence to Dr Craik
Background and Purpose. Inconsistent research findings make it unclear whether therapeutic exercise improves gait speed in community-dwelling elderly people. Using meta-analytical procedures, we examined the effect of therapeutic exercise on changing gait speed in community-dwelling older adults and the effect of type, intensity, and dose of therapeutic exercise on gait speed. Method. Studies were retrieved using a comprehensive database search. Two independent reviewers determined study eligibility based on inclusion criteria, rated study quality, and extracted information on study methods, design, intervention, and results. Data were combined to obtain an overall effect size, its 95% confidence interval, and a measure of significance. In addition, analyses to characterize the clinical relevance of the findings were performed. Results. One hundred seventeen studies were evaluated, with 24 studies (n=1,302 subjects) meeting the inclusion criteria for habitual gait speed and 18 studies (n=752 subjects) meeting the inclusion criteria for fast gait speed. Therapeutic exercise—or, more specifically, strength training and combination training (aerobic plus other exercise)—had significant effects (r=.145, P=.017; r=.176, P=.002, respectively) on habitual gait speed. High-intensity (effort expended by subjects) exercise and high-dosage (frequency and duration of exercise sessions) intervention also had a significant effect (r=.184, P=.001; r=.190, P=.001, respectively) on gait speed, whereas there was no effect for moderate- and low-intensity exercise or for low-dosage exercise. No exercise intervention affected fast gait speed in this analysis. Discussion and Conclusion. The results provide support for the belief that therapeutic exercise can improve gait speed in community-dwelling elderly people and that intensity and dosage are important contributing factors. The relatively weak correlation found between therapeutic exercise and gait speed merits further study. [Lopopolo RB, Greco M, Sullivan DH, et al. Effect of therapeutic exercise on gait speed in community-dwelling elderly people: a meta-analysis. Phys Ther. 2006;86:520–540.]
Key Words: Community-dwelling elderly people • Exercise • Gait • Gait speed • Therapeutic exercise
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