The aim of the Walk BEST study is to provide evidence that it is feasible to implement the technology assisted gait- focused walking program Walk-BEST™ in older adults with osteoporosis, and that this program is acceptable to this population.
men and women 70 years and older
able to walk independently with or without a walking aid
experienced a prior fracture after the age of 40, OR two falls in the past 12 months, OR who have a bone mineral density test (done as part of routine clinical evaluation) with a T-score < -2.5, OR on a Health Canada-approved anti-osteoporosis medication (oral or intravenous bisphosphonate, denosumab, teriparatide, or romozosumab) to reduce fracture risk or on a bisphosphonate drug holiday (planned treatment interruption)
fracture sustained in the past 12 months
unable to walk unsupervised because of active medical or neurocognitive reasons
unable to provide informed consent, or cannot communicate in English or French
Crossover
Device: Heel2Toe[TM] sensor
DeviceHeel2Toe is a new generation of wearables that provides real-time auditory feedback when the person takes a good step, one in which the step is initiated with a strong heel strike.
Technology-assisted therapeutic walking program
BehavioralCo-designed, evidence-based technology-assisted, therapeutic walking program developed by physiotherapy researchers, clinicians, and frail and non-frail seniors. It consists of training elements (derived through international consensus and endorsed by 600 older Canadians) for optimal gait pattern with the use of a biofeedback device, the Heel2Toe™ sensor, which is introduced to reinforce the gait optimizing training and encourage home practice.
Study recruitment rates (feasibility objective)
The study will be considered feasible if the investigator can recruit 28 participants
Study retention rates (feasibility objective)
The study will be considered feasible if ≥ 75 % of the sample completes the final assessment
Adherence to intervention (feasibility objective)
The intervention will be considered feasible if participants complete ≥ 65% of the prescribed number of walking sessions at the 6-month follow-up.
Perceived acceptability and usability of the Heel2Toe sensor (feasibility objective)
The acceptability outcomes will be based on an exit debriefing questionnaire. Usability of the Heel2Toe sensor will be quantified with items from the Digital Health Devices Usability Indicators.
Functional walking capacity
Six Minute Walk Test (6MWT)
Grip strength
Hand Dynamometer
Balance
Mini-Best Test (0-28; higher is better)
Functional leg muscle strength
30-second Chair stand test
Angular velocity of ankle during three phases of gait cycle, heel-strike, push-off, swing averaged over a walk of at least 50 steps
Degrees per second
Co-efficient of variation of angular velocity of ankle during three phases of gait cycle, heel-strike, push-off, swing averaged over a walk of at least 50 steps
Degrees per second
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