Feasibility of a Prescribed Walking Program in Older Adults with Dizziness: Challenges and Recommendations from a Pilot Pragmatic Randomized Controlled Trial

Authors

Amie Jasper, University of St. Augustine for Health SciencesFollow
Mary T. Blackinton, Rehab Essentials Inc.Follow
Joann Gallichio, Nova Southeastern UniversityFollow
Anne Galgon, St. Joseph's UniversityFollow

Abstract

Purpose: Walking for endurance is a component of vestibular rehabilitation (VR); however, there is no study on increasing the physical activity of older adults with peripheral vestibular hypofunction through a prescribed walking program. This pilot study aimed to assess the feasibility of conducting a pragmatic randomized controlled trial on a prescribed walking program in a clinical environment; specifically, to determine recruitment, data collection retention, and adherence, and to estimate the variances of treatment outcomes. Method: Seventeen patients were randomly assigned into vestibular rehabilitation with walking with pedometer (VRWP), vestibular rehabilitation with walking without pedometer (VRW), and VR only. Recruitment, data collection retention, and adherence were assessed. Timed-up and Go (TUG) test, Dizziness Handicap Inventory (DHI), modified Clinical Test of Sensory Integration of Balance (mCTSIB), and Dynamic Gait Index were taken at baseline and discharge. The International Physical Activity Questionnaire (IPAQ) was completed at baseline, discharge, and four-week follow-up. Results: The recruitment rate was 58.6% and data collection retention rate was 88% and 76% for vestibular and physical activity outcomes respectively. High adherence to walking goals was observed in 67% of the VRW group but not in the VRWP group. High adherence in completing walking logs was demonstrated in 75% of the VRWP group and 83% of the VRW group. Subject recruitment, data collection retention, adherence to walking goals, time constraints in clinical practice, and need for research and support staff were among the challenges identified from this pilot study. Conclusions: It is feasible to implement a prescribed walking program with substantial modifications. Future definitive trial is needed to support the effects of a prescribed walking program in older adults with peripheral vestibular hypofunction.

Author Bio(s)

Amie Marie Jasper PT, PhD, DPT is an assistant professor in the College of Rehabilitation Sciences, University of St. Augustine for Health Sciences, St. Augustine, FL, USA.

Mary Blackinton PT, EdD is a patient management expert at enTandem DPT, Rehab Essentials Inc., Columbia Falls, MT, USA

Joann Gallichio PT, DSc is an assistant professor in the College of Health Care Sciences, Nova Southeastern University, Tampa Bay, FL, USA

Anne Galgon PT, PhD is a professor in the Department of Physical Therapy, St. Joseph’s University, Philadelphia, PA, USA

Acknowledgements

The authors would like to thank the research sponsor, Advent Health (former Florida Hospital), grant sponsor Advent Health University (former Adventist University), and research team: Dr. Roy Lukman, Dr. Leana Araujo, Dr. Trevor Hicks, Elizabeth Rosales, Myrna Santiago, Susan Thome-Barrett and Grace Bacani.

Recommended Citation

Jasper A, Blackinton MT, Gallichio J, Galgon A. Feasibility of a Prescribed Walking Program in Older Adults with Dizziness: Challenges and Recommendations from a Pilot Pragmatic Randomized Controlled Trial. The Internet Journal of Allied Health Sciences and Practice. 2025 Apr 15;23(2), Article 16.