Aging, motor skill, and the energy cost of walking: implications for the prevention and treatment of mobility decline in older persons.

BACKGROUND Age-associated neural changes profoundly affect the biomechanics and energetics of walking, increase energy cost, and require novel approaches to exercise that focus on motor learning theory. METHODS We present a conceptual framework for motor skill in walking, its effect on the energy cost of walking, and the influence of the aging brain. RESULTS Motor learning theory and practice can be incorporated into interventions to promote skilled, energy efficient walking in older people. CONCLUSIONS An extensive literature on motor skill and motor learning, derived from neuroscience, sports medicine, and neurorehabilitation, can be applied to problems of walking in late life.