# Restoring Central Motor Control to Improve Community Mobility of Older Adults

> **NIH NIH R01** · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · 2021 · $584,598

## Abstract

Project Summary/Abstract
As many as 30 million older adults in the US have walking limitations which could impact community mobility.
Restriction in community mobility contribute to disability, institutionalization, and poor quality of life. Compared
to walking in clinical settings, community mobility requires rapid negotiation of complex, multi-sensorial, and
often variable and unpredictable environments. Successful community mobility requires rapid integration of
information both external (e.g. surface quality, distances) and internal (e.g. fatigue, pain) to the individual.
Integration of these inputs primarily occurs at the level of the central nervous system. Under normal conditions,
this integration favors automatic motor control with few demands on attention-related networks, primarily
located in the prefrontal cortex (PFC). As automatic motor control diminishes in older adults, activation of the
PFC during walking tasks increases. Age-related impairments in body systems (e.g. musculoskeletal,
cardiopulmonary) increase the demands of walking while concurrent impairments in the brain can reduce
capacity for motor control. The mismatch in demands and capacity can be magnified when walking occurs in
the context of complex community environments (e.g. uneven surfaces, attentional demands); therefore,
automatic motor control is likely a critical component of community mobility. Motor skill training (MST) is an
integrated intervention approach developed to improve walking. The goal of MST is restoration of automatic
motor control and behavioral flexibility during walking, which are needed for addressing environmental
challenges during community mobility. The MST approach may restore automatic motor control and provide
older individuals with the capacity to address environmental challenges and maintain community mobility. We
propose to test the effects of MST on community mobility and motor control. Community mobility will be
quantified by state of the art, objective measures from global position system (GPS) tracking, including activity
space (the area travelled by an individual in daily activities) and time away from home. Central motor control
will be assessed by wireless functional near-infrared spectroscopy (fNIRS) at the PFC during dual-task
walking. Further, we will assess the influence of individuals’ cognitive function and neighborhood environments
by neighborhood socioeconomic status and walkability audits on changes in community mobility. We will
leverage an ongoing randomized, 12-week efficacy trial of standard therapy compared to standard plus MST
(R01 AG045252; PI: Jennifer Brach) that is enrolling individuals aged 65 years and older with gait speeds 0.6-
1.2 m/s (n=248). The primary outcome of the parent trial is gait speed; our proposal will extend the outcome
from clinic-based measures to real world community mobility at baseline and 12, 24, and 36 week follow-up
visits. Results will provide evidence for intervention approaches to...

## Key facts

- **NIH application ID:** 10169212
- **Project number:** 5R01AG057671-04
- **Recipient organization:** UNIVERSITY OF PITTSBURGH AT PITTSBURGH
- **Principal Investigator:** Andrea L Rosso
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $584,598
- **Award type:** 5
- **Project period:** 2018-09-01 → 2024-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10169212

## Citation

> US National Institutes of Health, RePORTER application 10169212, Restoring Central Motor Control to Improve Community Mobility of Older Adults (5R01AG057671-04). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10169212. Licensed CC0.

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