Effect of a Supervised Hip Flexor Stretching Program on Gait in Frail Elderly Patients

• Published in: PM & R 2011-04, Vol.3 (4), p.330-335
• Main Authors: Watt, Jaclyn R., MS, Jackson, Keith, BS, Franz, Jason R., MS, Dicharry, Jay, MPT, Evans, Jonathan, MD, Kerrigan, D. Casey, MD
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Aging - physiology; Contracture - physiopathology; Contracture - rehabilitation; Double-Blind Method; Female; Frail Elderly; Gait - physiology; Hip Joint - physiopathology; Humans; Male; Muscle Stretching Exercises - methods; Muscle, Skeletal - physiopathology; Physical Medicine and Rehabilitation; Range of Motion, Articular; Treatment Outcome; Walking - physiology
• ISSN: 1934-1482; 1934-1563
• DOI: 10.1016/j.pmrj.2011.01.006

Objective To determine whether a 10-week supervised hip flexor stretching program in frail elderly subjects would increase peak hip extension, stride length, and gait speed and reduce anterior pelvic tilt during comfortable and fast-paced walking. Design A double-blinded, randomized, controlled trial. Setting Pre- and post-treatment assessments were performed in a gait laboratory and stretching exercises were performed outside of the laboratory, usually in the subjects' place of residence. Participants Seventy-four frail elderly individuals, with 41 subjects in the control group and 33 subjects in the treatment group. Intervention The treatment group completed a 10-week twice-daily hip flexor stretching program that was supervised twice weekly by a rehabilitation clinician. The control group completed a 10-week shoulder abductor stretching program. Main Outcome Measurements Dynamic peak hip extension and peak anterior pelvic tilt, stride length, and gait speed while walking at a comfortable pace and a fast pace, as well as passive hip extension range of motion. Results The treatment group showed significant increases in walking speed and stride length after the intervention but showed no significant changes in peak hip extension or anterior pelvic tilt during comfortable and fast-paced walking. The treatment group also showed significantly increased passive hip extension range of motion. Conclusions These results indicate that a simple stretching program is effective in improving some measures of age-related decline in gait function in frail elderly patients. The lack of consistent improvements in walking kinematics is attributed to the presence of multiple disabilities and limitations present in the frail subjects.