Walking Strong

WHEN PHYSICAL AND PSYCHOLOGICAL BARRIERS keep older adults from walking outdoors, they often experience a decline in physical activity and social interaction. That can ultimately lead to fragility, increased isolation and a decreased quality of life.

Ruth Barclay [BMRPT/87, PhD/08] says many of these barriers can be overcome. Barclay, associate professor of physical therapy in the College of Rehabilitation Sciences, is working on a series of studies of community ambulation, or “the ability to walk outside one’s home.”

Barclay, who holds a PhD in community health sciences and a bachelor’s degree in physical therapy from the U of M, as well as a master’s in health sciences from McMaster University, has been conducting research on stroke rehabilitation for about 20 years. Recently, she has expanded her focus to studying people over the age of 65, regardless of health condition.

She is co-leading a three-year randomized controlled trial of an outdoor walking program with Dr. Nancy Salbach of the University of Toronto. The study aims to remove barriers to seniors’ outdoor walking, including anxiety about walking difficulties, and to measure the benefits of getting out there regularly.

We spoke with Barclay about the multi-site outdoor walking project, which has participants in Winnipeg, Edmonton, Toronto and Montreal.

What motivated you to broaden your research to include older adults?

Many of the challenges that people with stroke told us about, regarding outdoor walking and social participation, also relate to older adults. We’re looking specifically at people who told us they had difficulty walking outside, whether it was for a physical reason, a lack of motivation, or they just didn’t have anyone to walk with.

It was important that we conduct parts of the study in groups, so participants can see other people with similar challenges and know they aren’t alone.

Why is the study being conducted in four cities?

The locations experience some differences in weather and have different population sizes. We may see differences across sites, which will be taken into account when we analyze the data.

What are some factors that keep people from walking outside?

Based on some of our previous research, the weather is definitely a factor, whether that be for people with stroke, osteoarthritis or older people in general. Another common one is endurance. If you can’t walk a comfortable distance, that may keep you inside. We had to make sure our study took place in spring and summer, in parks with a lot of benches so people could sit down, as well as public washrooms.

What does the study entail?

First, we held a five-hour active outdoor walking workshop. It included information stations and active practice to introduce physical activity guidelines, safety in exercising, fall prevention, pedometer use, Nordic pole use, balance exercises, foot care, walking patterns and goal setting. After the workshop, every participant was randomized into one of two groups.

One group met twice a week in city parks, with activities that gradually increased in difficulty over 10 weeks. The activities included walking at different speeds, on various surfaces, around obstacles, practising changes in posture, walking in a crowd and carrying objects.

In the other group, participants were asked to walk regularly on their own time, with a partner. They received weekly phone reminders offering support, encouragement, reinforcement of workshop information and review of walking goals.

What results have you seen so far?

We started with a pilot feasibility study. At the end of it, participants in the walking group told us that it had helped them to be more active. They found it motivating to see other group members improve, they felt safe walking as a group, their confidence and endurance increased, and their mood, energy and sense of well-being improved.

If we can encourage people to have more confidence about their walking abilities and improve things like balance, strength and endurance, they may be more likely to walk outside, whether it be at a park or to a friend’s house.