The Effect of High Intensity Walking on Frailty - PROJECT SUMMARY
Frailty impacts up to 60% of older adults and is a leading cause of dependency among older adults. Frail
older adults experience physical problems such as balance difficulties, weakness, decreased endurance, and
reduced walking speed that increase risk for falls, hospitalizations, institutionalization, and death. Physical
activity has multi-system health benefits and is the most recommended frailty management intervention, but
guidelines regarding the specific intensity of physical activity remain unclear. High intensity physical activity is
an established and safe therapeutic approach in other populations, but it is unclear as to the extent to which
high intensity activity can reduce or reverse frailty. This cluster-randomized study will compare a high intensity
walking (HIW) intervention to a self-selected, casual speed walking (CSW) intervention implemented within
retirement communities for pre-frail and frail older adults. We will randomize 10 retirement communities with 20
participants at each site (200 total participants) to either a 4-month HIW or CSW intervention. All participants
will receive 48, individually supervised overground walking sessions occurring within their retirement
community. At the beginning and end of the study, we will measure participants’ frailty, mobility, physical
functioning, balance, and total physical activity measured via an ActivPal accelerometer worn for a 1-week
observation period to compare which treatment strategy, HIW or CSW, worked better to reduce frailty (aim #1).
We will use the SHARE-Frailty Instrument to evaluate frailty as both a categorical (e.g. non-frail, pre-frail, or
frail) and a continuous outcome. This approach will allow us to determine how participants move between
frailty categories as well as within frailty categories in response to intervention. In aim #2, we will determine the
effect of walking intensity on mobility, physical functioning, balance, and total physical activity. We hypothesize
that HIW participants will show decreased frailty and improved mobility, physical functioning, balance, and
physical activity at 4 months. Currently, the optimal physical activity guidelines for older adults with frailty are
uncertain. Results from this study will provide important knowledge to inform activity guidelines for older adults
with frailty and information on a transformative approach to reducing frailty, improving function, and increasing
physical activity among a growing segment of the older adults population.
