A high intensity vs. casual speed walking intervention to reverse frailty among older adults: a cluster randomized controlled trial

Does walking at higher intensity improve frailty status more than walking at a comfortable self-selected pace in older adults who are prefrail or frail?

165 prefrail or frail adults aged 60+ in 14 retirement communities (105 in the analysis); mean age 79 years, 79% women

Cluster randomized — what this means trial with blinded — what this means assessors and participants; supervised walking at about 70% of maximum heart rate vs. casual pace under 60%, 45 minutes three times weekly for 16 weeks

• Frailty category improved in 69.6% (32/46) of the high-intensity group vs. 46.4% (26/56) of the casual-pace group (OR 2.91, 95% CI — what this means 1.19-7.13, p = 0.02)
• Gait speed gains favored high-intensity walking by 0.08 m/s (95% CI — what this means 0.03-0.13, p = 0.036)
• 6-Minute Walk Test distance favored high-intensity walking by 48.99 m (95% CI — what this means 21.1-76.9, p = 0.0088)
• Achieved intensity differed as intended (71% vs. 59% of max heart rate, p < 0.001), with similar session attendance (median 35 vs. 36, p = 0.07)

Older adults who were becoming frail walked three times a week for 16 weeks, either briskly or at their usual easy pace. Those who walked briskly were more likely to move out of a frail category and walked faster and farther by the end. A physical therapist can help someone decide what pace fits them.

One study is one piece of the picture. A physical therapist can help you decide what fits you.