The unique stepping and walking patterns in OTM are goal-oriented and progressive.
History of On the Move: Group Exercise for Improved Mobility in Older Adults® Research
The key exercises for On the Move: Group Exercise for Improved Mobility in Older Adults® (OTM) were developed first for a pilot clinical trial, which explored their impact on walking in older adults with walking difficulty (VanSwearingen et al 2009, VanSwearingen et al 2011). These exercises were developed by Physical Therapists and were designed to be delivered in a one-on-one session. Then, this intervention was tested in older adults with better walking ability (Brach et al 2013, Brach et al 2015). These studies found that the exercises, which focused on the timing and coordination of walking, improved overall walking difficulty in both groups of people. With input from older adults within the Greater Pittsburgh community, the intervention was then developed into a group class format (Brach et al 2016). With that, OTM was born. In a recent large-scale clinical trial, OTM was tested against a standard, community-based seated exercise program for older adults living in the Greater Pittsburgh area (Brach et al 2016). OTM was superior to the commonly-prescribed group exercise program in many different aspects of walking (Brach et al 2017).
The research supporting the OTM program was funded by the National Institute on Aging, the Patient-Centered Outcomes Research Institute, the University of Pittsburgh Claude D. Pepper Older Americans Independence Center, the University of Pittsburgh Clinical and Translational Science Institute, the University of Pittsburgh Aging Institute, and the University of Pittsburgh Medical Center.
Summary of On the Move: Group Exercise for Improved Mobility in Older Adults® Research
VanSwearingen et al 2009: Pilot randomized controlled trial to explore the impact of motor learning exercises that focus on the timing and coordination of walking, on walking ability, among older adults with walking difficulty. The motor learning intervention was compared to exercises that focused on walking, endurance, balance, and strength. Both interventions were performed one-on-one, under the supervision of a physical therapist. Both interventions resulted in improved gait speed; however, the motor learning intervention yielded larger improvements in the energy cost of walking, gait abnormalities, and self-reported walking confidence.
VanSwearingen et al 2011: The same pilot randomized controlled trial presented in VanSwearingen et al 2009. The motor learning intervention yielded significantly greater improvements in self-reported walking confidence and self-reported lower extremity physical function. Improvements were also found in walking speed, physical activity, and societal participation.
Brach et al 2013: Pilot randomized controlled trial to explore the impact of motor learning exercises that focus on the timing and coordination of walking, on walking ability, among older adults who walk well but have subclinical gait dysfunction. The motor learning intervention was compared to endurance-based treadmill walking; both groups included strength training. Both interventions were performed one-on-one, under the supervision of a physical therapist. Both interventions resulted in improved walking endurance; however, the motor learning intervention yielded larger improvements in gait speed and motor skill of walking.
Brach et al 2015: The same pilot randomized controlled trial presented in Brach et al 2013. The motor learning intervention yielded greater improvements than the treadmill program, in the double limb support time phase of gait, as well as the smoothness of walking.
Brach et al 2016: Pilot single-group trial that was designed to test the acceptability and safety of a community-based group exercise intervention, which focused on similar motor learning principles in VanSwearingen et al 2009, Brach et al 2013, and Brach et al 2015. The new group program was entitled On the Move: Group Exercise for Improved Mobility in Older Adults®. Older adults from the community were recruited to give input on the following class components: format/length, music, education, and group interaction. OTM was modified according to this feedback. Older adults participated in the 12-week program, which was found to be safe and acceptable. Preliminary evidence suggested that OTM led to improvements in walking speed, endurance, and motor skill.
Brach et al 2016: A protocol manuscript that describes the design of a comparative effectiveness trial to test the efficacy of the OTM program. Various stakeholders (e.g. community-dwelling older adults, senior management from local health system, clinicians that specialize in the geriatric population) participated in the design and focus of the study. The resulting protocol was a cluster randomized intervention to compare the effects on function, disability, and mobility of a standard group exercise program and the OTM. Stakeholders helped design the standard group exercise program to be similar to what is commonly offered in senior community centers. Older adults residing in independent living facilities and senior apartment buildings, as well as those that attend senior community centers, were identified as the target population. The group classes were held in the aforementioned settings.
Brach et al 2017: A cluster randomized controlled trial that compared the efficacy of the OTM intervention and a standard group exercise program, which was presented in Brach et al 2016. Thirty-two facilities (i.e. independent living facilities, senior apartment buildings, or senior community centers) were randomized to OTM or the standard group exercise program. Classes met for 50 minutes, 2x/week, for 12 weeks. Compared to those in the standard group exercise program, participants in OTM had greater improvements in walking speed and endurance.
PCORI 2017: The Patient Centered Outcomes Research Institute published a summary of findings of OTM’s cluster randomized trial in lay-language.
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On the Move: Group Exercise for Improved Mobility in Older Adults®
University of Pittsburgh
Department of Physical Therapy
Bridgeside Pointe 1
100 Technology Drive – Suite 210
Pittsburgh, PA 15219