Study Helps Veterans Strengthen Gait and Balance
For Coast Guard Veteran Robert Mead, 88, a few falls, one in which he toppled over headfirst, gave him cause for concern, especially since his brother also had experienced similar issues with aged-related falling that resulted in serious injury.
Mead wanted help to maintain his balance and avoid injury, so he called the VA Maryland Health Care System for help.
Army Veteran Frank Meely, 77, suffered painful back issues when one of his VA physical therapists recommended that he work on his gait and balance.
Army Veteran Willie Latimore, who turns 77 this year, said that although he walked nearly 8 miles a day in the job he had held up to age 64, he began having difficulty with his gait. His primary care provider recommended he focus on gait and balance to avoid falling, one of the major threats for injury and death among the elderly.
With more than one in every four older adults falling annually, falls are the leading cause of hospitalizations, loss of independence and death for this group. When an older adult falls once, the risk of falling again can double and thus, fall prevention is a key to keeping seniors healthy, independent and out of Emergency Departments.
Fall prevention is why the trio found themselves at the Baltimore VA Annex participating in a pilot research study designed to help Veterans, age 65 and older, with gait and balance. “Older people are more at risk for falls, which is the leading cause of injury for that group. They can fall due to a variety of reasons, including side effects of medications, underlying issues such as bone health, hypotension, foot problems, or weak leg muscles,” said Dr. Susan Conroy, principal investigator of the Gait Better study. “Many older people will also fall when they become distracted while walking.”
The Gait Better study’s goal is to train older Veterans in a personalized setting using a virtual screen and safety harness to feel more secure when walking and improve balance and confidence to successfully negotiate obstacles even when distracted. The training combines walking speed, endurance, and motor planning practice with dual task attention and decision-making skills.
The other goal of the study is to determine if the study’s intervention can carry over in real life and to determine if Veterans are receptive to the treadmill with a virtual reality twist. “An attached camera interacts with sensors on the participants’ feet while they walk, projecting their movement onto the virtual reality screen as the virtual distractions get in the path,” Conroy said.
In the study, the virtual reality screen is attached to a treadmill and the program presents a goal of walking to a certain place or building within the virtual reality world. Participants walk following prompts to avoid puddles, caution signs, people, traffic, and other distractions. During the study, participants walk on the treadmill twice a week for 45 minutes for 7 weeks.
“It wasn’t easy,” said Latimore, who appreciated the one-on-one time with researchers despite being a little surprised by the level of the challenge after having worked in a job that required miles of daily walking. “It took me awhile to get in sync with that machine,” he said.
Mead found that participation in the study improved his walk. “It helped with my balance and my focus,” he said.
“It was fun but hard work,” Meely said, noting that he had already been walking fine but the project helped him strengthen his legs, and as a result, his balance.
The virtual reality world of the screen attached to the treadmill gives participants the feel of a video game with two scenarios—an urban and a park environment. After their segment of the study is completed, participants will hear from the researchers by phone for six months as a follow up and to track whether they experienced any falls. “The goal is to see if the intervention can prevent falls and carry over into real life,” said Conroy. “Older Veterans practice walking in a fun and realistic virtual space with the goal of reducing fall risk.”
Falling is not just a matter of bad luck, especially as one ages. With the right training, preventing falls and reducing injuries like broken hips becomes a balancing act.
For more information about the Gait Better study, please call 410-637-3213.