Aging, Community and Health Research Group (ACHRU)

McMaster University

Moving Up Stream:
Preventative Approaches to Preclinical Mobility Limitation

Welcome to the Mobility Self-Management Program webpage.

You are taking part in the Mobility Self-Management Program because you have noticed a change your ability to walk and climb the stairs the way you used to. You want to improve how you move!

The information you find here can help you do just that. You will find a summary of each Self-Management and Exercise Session, videos of the Walking Patterns so you can practice at home, links to resources in the community to help you maintain and improve your mobility…and more!

Photo of feet walking on path

Weekly Program Summaries

Click here to download the session summary

Exercise List
Warm-Up Included review of posture and core breathing
Station 1 Grapevine
Station 2 Box Steps
Station 3 Lateral Side Steps with Squats
Station 4 Forward Walking
Add cognitive task: Recite the months of the year in reverse order
Station 5 Backward Walking
Station 6 Figure-8 Walking

Click here to download the session summary

Exercise List
Warm-Up Included review of posture and core breathing
Station 1 Grapevine
Station 2 Box Steps
Station 3 Rest (Step-Ups or Laps)
Station 4 Lateral Side Steps with Squats
Station 5 Forward Walking
Add cognitive task: Recite the months of the year in reverse order
Station 6 Rest (Step-Ups or Laps)
Station 7 Backward Walking
Station 8 Figure-8 Walking
Cool-Down Guided body scan (seated or lying down)
Possible adaptations:
  • Narrower base of support for regular walking stations
  • More difficult cognitive task for any station (suggest counting backward from 100 in intervals of 3 – 100, 97, 94, 91 etc…)

Click here to download the session summary

Exercise List
Warm-Up Included review of posture and core breathing
Station 1 Grapevine
Station 2 Box Steps
Station 3 M-Steps
Station 4 Forward Walking
Add cognitive task: Counting backwards from 100 in intervals of 3 – 100, 97, 94, 91 etc…
Station 5 Rest (Step-ups or Laps)
Station 6 Backward Walking
Add cognitive task: Reciting the months of the year in reverse order
Station 7 Figure-8 Walking
Make the task more difficult: Try a narrow base of support (tandem or heel-toe walking)
Possible adaptations:
  • Narrower base of support for forward walking, backward walking, figure-8 walking stations
  • Increasing the pace of any stepping pattern
  • Add a more difficult cognitive task for any station (i.e. list the provinces of Canada from West to East)

Click here to download the session summary

Exercise List
Warm-Up Included review of posture and core breathing
Station 1 Grapevine
Station 2 Box Steps
Station 3 M-Steps
Station 4 Across Body Steps
Station 5 Rest (Step-ups or Laps)
Station 6 Lateral Side Steps with Squats
Station 7 Backward Walking
Make the task more difficult: Try a narrow base of support (tandem or heel-toe walking)
Station 8 Figure-8 Walking
Make the task more difficult: Try walking on your toes
Possible adaptations:
  • Narrower base of support for forward walking, backward walking, figure-8 walking stations
  • Increasing the pace of any stepping pattern
  • Add a more difficult cognitive task for any station (i.e. list the provinces of Canada from West to East)

Click here to download the session summary

Exercise List
Warm-Up Included review of posture and core breathing
Station 1 Box Steps
Make the task more difficult: Add a cognitive task if able
Station 2 M-Steps
Make the task more difficult: Add a cognitive task if able
Station 3 Across Body Steps
Make the task more difficult: Add a cognitive task if able
Station 4 Rest (Step-ups or Laps)
Station 5 Backward Walking
Make the task more difficult: Try a narrow base of support (tandem or heel-toe walking)
Station 6 Lateral Side Steps with Squats
Station 7 Figure-8 Walking
Make the task more difficult: Try walking on your toes
Station 8 Forward Walking
Make the task more difficult: Try walking on toes, in tandem (heel-toe walking) or increase pace
Cool-Down SAVASANA (seated or lying down)
Possible adaptations:
  • Narrower base of support for forward walking, backward walking, figurewalking stations
  • Increasing the pace of any stepping pattern
  • Add a more difficult cognitive task for any station (i.e. list the provinces of Canada from West to East, count backward from 100 by 3’s or 7’s, recite every other letter of the alphabet, name as many objects as possible beginning with a particular letter)

Click here to download the session summary

Exercise List
Warm-Up Included review of posture and core breathing
Station 1 Box Steps
Make the task more difficult: Add a cognitive task if able
Station 2 M-Steps
Make the task more difficult: Add a cognitive task if able
Station 3 Across Body Steps
Make the task more difficult: Carry an object
Station 4 Rest (Step-ups or Laps)
Station 5 Grapevine
Make the task more difficult: Complete 1 Grapevine (right to left, left to right), then turn 90° to the right. Repeat, turning to the right after each Grapevine.
Station 6 Lateral Side Steps with Squats
Make the task more difficult: Add a cognitive task if able
Station 7 Figure-8 Walking
Make the task more difficult: Try a side shuffle
Station 8 Forward Walking
Make the task more difficult: Try walking on toes, in tandem (heel-toe walking) at as fast a pace as possible.
Cool-Down Qi Gong
Possible adaptations:
  • Narrower base of support for forward walking, backward walking, figurewalking stations
  • Increasing the pace of any stepping pattern
  • Add a more difficult cognitive task for any station (i.e. list the provinces of Canada from West to East, count backward from 100 by 3's or 7's, recite every other letter of the alphabet, name as many objects as possible beginning with a particular letter)

Click here to download the session summary

Exercise List
Warm-Up Included review of posture and core breathing
Station 1 Box Steps
Make the task more difficult: Add a cognitive task if able
Station 2 M-Steps
Make the task more difficult: Add a cognitive task if able
Station 3 Across Body Steps
Make the task more difficult: Carry an object
Station 4 Rest (Step-ups or Laps)
Station 5 Grapevine
Make the task more difficult: Complete 1 Grapevine (right to left, left to right), then turn 90° to the right. Repeat, turning to the right after each Grapevine.
Station 6 Lateral Side Steps with Squats
Make the task more difficult: Add a cognitive task if able
Station 7 Figure-8 Walking
Make the task more difficult: Try a side shuffle
Station 8 Forward Walking
Make the task more difficult: Try walking on toes, in tandem (heel-toe walking) at as fast a pace as possible.
Cool-Down Qi Gong
Possible adaptations:
  • Narrower base of support for forward walking, backward walking, figurewalking stations
  • Increasing the pace of any stepping pattern
  • Add a more difficult cognitive task for any station (i.e. list the provinces of Canada from West to East, count backward from 100 by 3's or 7's, recite every other letter of the alphabet, name as many objects as possible beginning with a particular letter)

Click here to download the session summary

Exercise List
Warm-Up Included review of posture, core breathing and pelvic floor
Station 1 Box Steps
Make the task more difficult: Add a cognitive task if able
Station 2 M-Steps
Make the task more difficult: Add a cognitive task if able
Station 3 Across Body Steps
Make the task more difficult: Carry an object
Station 4 Rest (Step-ups or Laps)
Station 5 Grapevine
Make the task more difficult: Complete 1 Grapevine (right to left, left to right), then turn 90° to the right. Repeat, turning to the right after each Grapevine.
Station 6 Forward Walking
Make the task more difficult: Forward walking 4 steps, side shuffle 4 steps, backward walking 4 steps, side shuffle 4 steps (you should have made a square). Repeat in opposite direction.
Station 7 Figure-8 Walking
Make the task more difficult: Try a side shuffle while carrying an object.
Station 8 Backward Walking
Make the task more difficult: Try walking on toes, in tandem (heel-toe walking) at as fast a pace as possible.
Cool-Down Qi Gong
Possible adaptations:
  • Narrower base of support for forward walking, backward walking, figure-8 walking stations
  • Increasing the pace of any stepping pattern
  • Add a more difficult cognitive task for any station (i.e. list the provinces of Canada from West to East, count backward from 100 by 3's or 7's, recite every other letter of the alphabet, name as many objects as possible beginning with a particular letter)

Click here to download the session summary

Exercise List
Warm-Up Included review of posture, core breathing and pelvic floor
Station 1 Box Steps
Make the task more difficult: Add a cognitive task if able and carry an object
Station 2 M-Steps
Make the task more difficult: Add a cognitive task if able and carry an object
Station 3 Across Body Steps
Make the task more difficult: Add a cognitive task if able and carry an object
Station 4 Rest (Step-ups or Laps)
Station 5 Grapevine
Make the task more difficult: Complete 1 Grapevine (right to left, left to right), then turn 90° to the right. Repeat, turning to the right after each Grapevine.
Station 6 Figure-8 Walking
Make the task more difficult: Try a side shuffle while carrying an object.
Station 7 Electric Slide
Station 8 Backward Walking
Make the task more difficult: Try walking on toes, in tandem (heel-toe walking) at as fast a pace as possible.
Cool-Down Qi Gong
Possible adaptations:
  • Narrower base of support for forward walking, backward walking, figure-8 walking stations
  • Increasing the pace of any stepping pattern
  • Add a more difficult cognitive task for any station (i.e. list the provinces of Canada from West to East, count backward from 100 by 3's or 7's, recite every other letter of the alphabet, name as many objects as possible beginning with a particular letter)

Click here to download the session summary

Exercise List
Warm-Up Included review of posture, core breathing
Station 1 M-Steps
Make the task more difficult: Add a cognitive task if able and carry an object
Station 2 Across Body Steps
Make the task more difficult: Add a cognitive task if able and carry an object
Station 3 Rest (Step-ups or Laps)
Station 4 Grapevine
Make the task more difficult: Complete 1 Grapevine (right to left, left to right), then turn 90° to the right. Repeat, turning to the right after each Grapevine.
Station 5 Figure-8 Walking
Make the task more difficult: Try a side shuffle while carrying an object.
Station 6 Electric Slide
Station 7 Backward Walking
Make the task more difficult: Try walking on toes, in tandem (heel-toe walking) at as fast a pace as possible.
Cool-Down Qi Gong
Possible adaptations:
  • Narrower base of support for forward walking, backward walking, figure-8 walking stations
  • Increasing the pace of any stepping pattern
  • Add a more difficult cognitive task for any station (i.e. list the provinces of Canada from West to East, count backward from 100 by 3's or 7's, recite every other letter of the alphabet, name as many objects as possible beginning with a particular letter)

Download Your Weekly Action Plan Download A Weekly Action Plan Sample

Videos and Guides

  • Step your right foot to the right, step your left foot behind your right, step your right foot to the side and bring your feet together.
  • Step your left foot to the left, step your right foot over your left, step your left foot to the side and bring your feet together.
  • Step forward with your right foot, step your left foot over your right, step your right foot back and then your left foot back to meet your right.
  • Step forward with your left foot, step your right foot over your left, step your left foot back and then your right foot back to meet your left.
  • Step your right foot to the right and squat, then step your left foot to meet your right and squat. Repeated two more times to the right.
  • Now move your left foot to the left and squat, then step your right foot to meet your left and squat. Repeat 2 more times to the left.
  • It this sequence, your steps will trace the letter M both forward and backward.
  • Starting with your right foot, take a large step forward and have your left foot follow to meet your right.
  • With your right foot, take a small diagonal step back wards (towards the right) and have your left foot follow to meet the right. With your right foot again, take a small diagonal step forward (to the right) and have your left foot follow to meet the right.
  • Next, take a large step backward with your right foot and have your left foot follow to meet the right.
  • Repeat the sequence, tracing the M backward, starting with your left foot and moving to the left.
  • Step your right foot over your left foot and then tap your left foot out to the left, then step your left foot across the right and then tap your right foot out to the right. Repeat this four times moving in a forward direction.
  • Now step your left foot behind your right and tap your right foot out to the right, then step your right foot behind your left and tap your left foot out to the left. Repeat this 4 times moving in a backward direction.
  • Start with the Grapevine – Step your right foot to the right, step your left foot behind your right, step your right foot to the side and bring your feet together. Step your left foot to the left, step your right foot over your left, step your left foot to the side and bring your feet together.
  • Next, starting with your right foot, take 3 steps back then tap forward with your left foot. Then, step forward on your left foot and tap your right foot behind. Step back on your right foot and tap your left foot in front. Step forward on your left foot and tap your right foot behind. Finally, step forward on your right foot and turn to your left.
  • Repeat this sequence with your body facing all 4 directions.

The dual-task method, which requires people to perform multiple tasks simultaneously, has been used to study the effect of thinking (cognitive) tasks on balance. It has been shown that the ability to maintain balance is reduced when performing 2 or more tasks at the same time.

Studies suggest that older adults who have difficulty performing dual-tasks are at increased risk for falls. Other studies have shown that when asked to perform a simultaneous walking and talking task, participants were found to either stop walking or take longer to complete the walking task. These findings support the idea that mobility is affected when cognitive and mobility tasks are performed together, which is often the case in everyday life.

Our intervention program will combine cognitive tasks with a variety of walking sequences to achieve a training effect and to more closely resemble real word situations.

Examples will include:

  • Increasing the difficulty of the walking sequence itself (changing directions, increasing the speed of movement)
  • Modifying the environment in which the walking sequence is performed (over uneven ground, in a confined space, in a crowd of people)
  • Reciting a cognitive task (naming the months of the year in reverse order, counting backward by 3s or 7s from 100) while completing a walking task
  1. Decide what you want to accomplish
  2. Look for alternative ways to accomplish your goal
  3. Start making short-term plans by making action plans
  4. Carry out your action plans
  5. Check your results
  6. Make changes as needed
  7. Reward yourself

What's New

Walking speed, part 1:
How fast should I walk to cross the road safely? Fast facts about walking speed

Posted Jul 21, 2014

Read Article


Walking speed, part 2:
What can you do to improve walking speed?

Posted Sep 21, 2014

Read Article

Resources

Access Physiotherapy HNHB – A guide to accessing physiotherapy services in the communities of Hamilton, Niagara, Haldimand and Brant

Physiotherapy, Exercise and Falls Prevention – Information from the Hamilton Niagara Haldimand Brant (HNHB) Local Health Integration Network (LHIN) about access to physiotherapy as well as free exercise and fall prevention classes

hnhbhealthline.ca – Local programs and services that provide support, health care, recreational and social opportunities for seniors

Canadian Physical Activity Guidelines for Older Adults

Hamilton Conservation Authority and the Waterfront Trail – Great places to walk right in your neighbourhood

Physical Activity Centre for Excellence – McMaster University

Contact Information

Sinead Dufour, Co-Principle Investigator
(905) 525-9140 Ext. 22481
sdufour@mcmaster.ca

Julie Richardson, Co-Principle Investigator
(905) 525-9140 Ext. 27811
jrichard@mcmaster.ca

Gail Simpson, Physiotherapist
Co-Facilitator of the Self-Management sessions

Jessica Kuntz, Kinesiologist
Co-Leader of the Exercises sessions

Susanne Sinclair, Clinical Research Coordinator
(905) 525-9140 Ext. 27810
ssincla@mcmastr.ca

Hamilton Integrated Research Ethics Board
Office of the Chair
(905) 521-2100, Ext. 42013.