Identifying Outdoor Winter Walking Programmes and Resources for Older Adults: A Scoping Review of the Grey Literature

Abstract

Purpose:

The objective was to synthesize outdoor winter walking programmes and resources for older adults, identified as a priority by the Winter Walk team comprised of older adults and researchers and trainees from the rehabilitation and geography sciences.

Method:

A scoping review of web-based grey literature was conducted. Teams of two reviewers independently assessed eligibility and extracted data. Web-based resources were included if their content dealt with adults ≥65 years of age; an outdoor winter walking programme, intervention, or general resource; and was written in English.

Results:

Twenty-seven website resources were eligible and included in the review. Resources were from Canada or the United States and included information provided by government, non-profit organizations, media, and businesses. All resources focused on some aspect of winter walking safety and only one mentioned a winter walking programme.

Conclusions:

Web-based resources for outdoor winter walking were synthesized to assist older adults and clinicians with access to safe outdoor winter walking information.

For older adults, being able to walk outside is important in maintaining physical activity and community participation. It is estimated that over 35% of adults aged 45 and older walk outdoors fewer than 3 days a week.¹ Restricted walking is associated with frailty,² decreased mobility, decline in self-care ability, social isolation, and reduced health-related quality of life.^3,4 Walking is the most common method of physical activity for older adults.⁵

Low levels of physical activity in older adults have been associated with colder outdoor temperatures, and lower amounts of daylight.⁶ Decreased outdoor walking in winter has been associated with a decline in physical activity,⁷ and steps per day are significantly decreased in older adults during winter months.⁸ The risks of falls and fear of falls are increased in the winter, with icy conditions.^{9, 10, 11, 12}

It is known that falls can have many negative outcomes for older adults, such as fractures, functional decline, and death.¹³ Fear of falling in the winter is a common concern for older adults¹¹ and safety is a consideration when walking outdoors in the winter. A study in the province of Ontario demonstrated increased odds of adults 65 years or older having falls leading to emergency room visits if average daily temperatures were −0.3 to <3°C or −4.1 to <−0.3°C compared to ≥3.0°C.¹⁴ The chance of falling was found to be lower on days with colder weather, when average temperature was <−9.4°C.¹⁴ For up to 7 days after a snowfall, odds of unintentional falls leading to an emergency room visit were increased for older adults, compared to days with no snowfall.¹⁴ Interestingly, these findings were fairly similar across all age groups.¹⁴ In a study based in Montreal, days with increased outdoor falls requiring an ambulance had snow or freezing rain occurring 1–3 days prior, often with a drop in temperature, leading to icy conditions.¹⁵ Forty-one percent of people who fell outdoors and were injured were 65 years of age or older.¹⁵

Not surprisingly, Canadian older adults are more likely to walk outdoors in good weather months, as compared to January, a cold winter month.¹ People may walk outdoors in the winter for exercise, for leisure, or to get to transportation (such as walking to a car or transit). The challenge of seasonal weather changes is an important issue. With average temperatures in most Canadian cities well below freezing in winter,¹⁶ the resulting weather can lead to decreased walking, physical activity, and social isolation for older adults. A recent scoping review of winter mobility (including equipment use) found only 23 peer reviewed publications that addressed concepts related to effectiveness of devices, strategies, or recommendations for moving around in the winter.¹⁷ That review was not focused on walking specifically.

Outdoor winter walking for older adults is an understudied area that needs more research, evidence, and development. Therefore, a scoping review that focuses specifically on outdoor winter walking programmes and resources for older adults is necessary. The grey literature was a good starting place to synthesize publicly available information about winter walking, as governments and organizations in Canada or the United States, countries with winter weather, are likely to have information on safe winter walking as part of public health and seniors’ health initiatives. This topic is of interest to Canadian rehabilitation professionals who work with older adults having concerns regarding outdoor winter walking safety and resources.

Objective

The objective of this scoping review was to synthesize information on outdoor winter walking programmes and resources for older adults from Canada or the United States.

Methods

Protocol and registration

A protocol was developed a priori guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) Checklist, and methodological frameworks by Levac and colleagues, Colquhoun and colleagues, and Arksey and O’Malley.^{18, 19, 20} This protocol was revised by the research team and made publicly available through Open Science Framework.²¹ The protocol describes both an academic/peer-reviewed literature search and grey literature search. This paper describes only the results of the grey literature search. While we initially aimed to synthesize the peer-reviewed literature, it was not feasible to complete this part of the review. The peer-reviewed literature was searched first; however, because of the time lapse between the peer-review literature search and the grey literature search, we did not have the resources to update the peer-review literature search. It is worthwhile to focus on the grey literature as it could be well tailored to the older adult population and be a good source of practical information for clinicians. We needed to thoroughly examine grey literature to gather anything that is known or could contribute to our understanding. Ultimately, there is a need to develop evidence-based programmes that are contextually relevant – we wanted to learn if anyone had taken the initiative in this area in developing programmes or sharing resource information to safely navigate winter walking.

Members of the “Winter Walk team” at the University of Manitoba, Winnipeg, Canada identified the research question as a priority. The 11 members of the team were researchers from the fields of physical therapy, occupational therapy, kinesiology, geography, and library sciences. The team was also comprised of graduate student trainees and two older adult members of the community from the Manitoba Association of Seniors Centres and Active Aging in Manitoba. This is the second of two scoping reviews identified as priorities of the Winter Walk team.²²

Eligibility criteria

Grey literature were searched in consultation with a health sciences librarian. Multiple sources of grey literature (e.g., government publications, public policies, organization web-based resources) were reviewed. Inclusion criteria included that sources were written in English; were from Canada or the United States; described outdoor winter walking programmes, interventions, or resources; and targeted older adults (age ≥65).

“Programmes” and “interventions” were defined as community programmes or exercise groups for older adults focused on winter outdoor walking (e.g., walking groups or individual walking programmes). The “resources” category included summaries of resources for older adults related to winter walking: for example, lists of available resources in a city/location, contact information for people resources, advice or information on equipment to use, clothing, and tips or tricks to stay warm, prevent falls, and walk safely.

Exclusions were: sources reviewing topics such as indoor walking, general physical activity, or exercise during the winter (e.g., yoga, aerobic, balance or muscle strengthening exercise classes; skiing, snowshoeing).

Information sources and search

Grey literature was retrieved from various website sources including, but not limited to, health organizations, older adult organizations, and government webpages. Nine authors (OA, RB, HC, SM, JR, CS, GS, NS, SW) searched online for relevant documents available through: theses, Google/Google Scholar, older adult and active ageing associations and organizations, government publications, and websites in Manitoba and Ontario. The focus on Manitoba and Ontario was due to the team members being from Winnipeg, Manitoba and Toronto, Ontario. Searches were completed by May 28, 2021. See Table 1 for further details of the grey literature search and search terms used. Team members received training and instructions from the health sciences librarian (HL) regarding searches of university repositories, Google/Google Scholar search terms and advanced searching, and using the domain filter in Google Advanced Searching for government documents.

Table 1.

Search Strategy

Search terms
(For websites that allowed advanced searches)	Geriatric* OR elder* OR senior* OR aging OR aged OR retirement OR “older adult*” AND Walk* OR ambulat* OR “physical* active*” AND “Cold temperature” OR winter OR icy OR snow* OR slush OR freez* OR ice OR frozen OR slippery
Sources
Theses/dissertations	Limits: (1) ProQuest (International database of theses/dissertations, 100+ countries), (2) University of Manitoba (MSpace) and (3) University of Toronto (TSpace) N.B. Use Medline search strategy outlined in protocol for ProQuest and limit search to theses/dissertations
Google/Google Scholar	Limits: Hand search up to 10 pages
Relevant associations/organizations	Limits: American College of Sports Medicine (ACSM), Canadian Society for Exercise Physiology (CSEP), Active Aging Canada, The Canadian Academy of Sport and Exercise Medicine (CASEM), Canadian Kinesiology Alliance, Exercise is Medicine, ParticipACTION, Active Aging Canada, Active Aging in Manitoba, Manitoba Association of Senior Centres, Canadian Association for Retired Persons, Osteoporosis Canada, The Arthritis Society, Heart & Stroke Foundation of Canada, Cardiac Health Foundation of Canada, Parkinson Canada, Diabetes Canada, MS Society of Canada, Canadian Mental Health Association
Government publications/websites	Limits: (1) Municipalities (Winnipeg and Toronto), (2) Provinces (Manitoba and Ontario), (3) Canada

Selection of sources of evidence

Grey literature was organized using an Excel spreadsheet. All grey literature involved review of web-based content. This included theses and dissertations that were available through the electronic searches of the university repositories. Each website was reviewed by two independent reviewers, using the inclusion and exclusion criteria. Five authors participated in this process (RB, HC, SM, GS, SW). If there was conflict as to whether or not a website should be included, two reviewers (RB, SM) resolved the conflict. Data extraction was completed by two authors (RB, SM). The list of included grey literature was shared with the community organization members of the Winter Walk team.

Data charting process

A data-charting form was developed by two reviewers (RB, SM) with categories that described each website. This was documented using an Excel spreadsheet.

Data items

The following information was collected: source, title, topic (walking advice, footwear, aids, etc.), type of resource (article, video, report, etc.), source type (government, non-profit, media, business, or other), target audience (older adults, diagnosis specific, etc.), country of origin, date of last update, additional notes, and website address.

Synthesis of results

The data were summarized in the tables as described above and studies were organized by country of origin and source type. This method of organization was chosen to help categorize resources based on search results and based on community member comments.²³ Two members of the research team (RB, SM) reviewed the summarized data to identify patterns or common topics/categories.

Consultation

The list of grey literature websites that appeared to fit the inclusion and exclusion criteria was circulated to the two community member organization representatives to determine whether the content was appropriate for their members. Due to ongoing restrictions with COVID, an in-person meeting was not arranged. However, information was shared and discussion occurred through email.

Results

The grey literature search revealed 91 websites, 88 identified through the search, one from an included website, and two from community member recommendations. One duplicate was removed, leaving 90 websites to be reviewed. Sixty-two were excluded and 28 websites were included. One source was further excluded based on community member consultation, leaving 27 resources. All sources included resources related to outdoor winter walking. One was a newsletter that also described a Nordic Walking group programme in the Northwest Territories that appeared to occur in winter conditions. See Figure 1 for the PRISMA format flow chart and reasons for exclusion.

Figure 1. Flow chart.

Twenty-two websites were from Canada with an additional five from the United States. Despite some of the search strategy components (Table 1) being limited to the provinces of Manitoba and Ontario, some of the resources were from other areas of Canada and the United States. Of the Canadian websites, six were from city, provincial, or federal governments, seven were from non-profit organizations, two were media, four from businesses, and three from other sources. For the websites from the United States, one was non-profit, one was media, and three were from businesses.

Types of resources included fact sheets, pamphlets, booklets, videos, media reports, and blogs. All resources and programme information were about winter outdoor walking or were larger all-season resources with a small section specific to outdoor winter walking. All resources targeted either older adults or the general population. The main focus of the content was on tips for safe outdoor walking including safe footwear, clothing, walking strategies, aids, and falls prevention. See Table 2 for a summary of the outdoor winter walking resources.

Table 2.

Summary Results

Source	Title	Topic	Winter walking programme or resource	Type of resource	Source type	Target audience	Location	Last update	Additional notes	Webpage
Canada
Government of Canada	Wind Chill: The Chilling Facts	Winter safety advice	Resource	Fact sheet	Government	General population	Canada	2014		https://www.canada.ca/content/dam/eccc/migration/main/meteo-weather/80b0f2af-9697-4bee-ab17-d401ebba5b4b/windchill_factsheet_en.pdf
Government of Alberta	Winter Walking Tips: Lower Your Risk of Falling	Winter walking safety advice	Resource	Information sheet	Government	Adults	Alberta, Canada	March 18, 2019	Refers to “Walk Like a Penguin” video	https://myhealth.alberta.ca/Alberta/Pages/winter-walking-tips.aspx
Alberta Health Services	Walk Like a Penguin – Video	Winter walking safety advice	Resource	Video	Government	Adults	Alberta, Canada	Not reported		https://www.albertahealthservices.ca/info/page12619.aspx
City of Toronto	Winter Safety Tips	General winter safety tips for pedestrians, drivers, etc.	Resource	Information	Government	General population	Toronto, Canada	Not reported	See pedestrian safety tips tab – very general – some information such as snow clearing specific to Toronto	https://www.toronto.ca/services-payments/streets-parking-transportation/road-maintenance/winter-maintenance/winter-safety-tips/
City of Toronto	Health Impacts of Extreme Cold Weather	Winter safety advice	Resource	Information	Government	General population	Toronto, Canada	Not reported		https://www.toronto.ca/community-people/health-wellness-care/health-programs-advice/extreme-cold-weather/health-impacts-of-extreme-cold-weather/
Trauma NB	Safe Winter Walking Campaign	Winter walking safety advice	Resource	Pamphlet	Government	General population	New Brunswick, Canada	Feb 2019	Go to safe winter walking tab	https://nbtrauma.ca/new-brunswickers/falls/
The Arthritis Society	Winter Tips for Seniors with Arthritis (Advice on Footwear)	Winter walking safety advice and winter safety	Resource	Information	Non-profit	Older adults with arthritis	Toronto, Canada	2021	Tips refer to both indoors and outdoors	https://arthritis.ca/living-well/forward-living/arthri-tips/winter-tips-for-seniors-with-arthritis
Canada Safety Council	Safety Tips for Winter Walking	Winter walking safety advice	Resource	Information	Non-profit	Older adults	Ontario, Canada	Not reported		https://canadasafetycouncil.org/senior-safety/safety-tips-winter-walking
Active Aging Canada	Nordic Walking in Fort Providence in ‘Celebrating Healthy Active Lives’	Winter walking programme summary and equipment review (winter safety)	Winter walking programme resource	Newsletter	Non-profit	Older adults	Ontario, Canada	Jan 2011	Page 3: Walking with poles, Page 8: Winter boots grips	https://www.activeagingcanada.ca/assets/pdf/newsletters/2011_01_winter.pdf
Participation Newfoundland and Labrador	Physical Activity Toolkit for Older Adults	Physical activity advice – small winter safety advice section	Resource	Information	Non-profit	Older adults	Newfoundland and Labrador, Canada	Not reported	Page 15 has a brief winter tip “Dress the Part” Re: Walking poles and ice grips	http://seniorsnl.ca/app/uploads/2018/05/Older-Adult-Physical-Activity-Toolkit.pdf
Active Aging Canada	Walk Away Winter Blues	Winter walking safety advice	Resource	Information	Non-profit	Older adults	Canada	June 4, 2020		https://www.silvertimes.ca/home/active-living/walk-away-winter-blues
Osteoporosis Canada	Navigating Winter	Winter walking safety advice and winter driving advice	Resource	Newsletter	Non-profit	People with osteoporosis	Canada	Feb 13, 2020		http://www.osteoporosis.ca/wp-content/uploads/2016-01-13-COPING-Navigating-Winter-FINAL.pdf
Fall Prevention Month	Safe Winter Walking Campaign	Winter walking safety advice	Resource	Article, report	Non-profit	Older adults, caregivers	Ontario, Canada	Aug 2017	Links to articles, fact sheets, and safety information	https://www.fallpreventionmonth.ca/adults/take-action-adults/ideas-for-activities-/safe-winter-walking-campaign-
Vancouver Sun	Five Things: Walk Like a Penguin and Other Safety Tricks for Icy Conditions	Winter walking safety advice	Resource	News article	Media	Adults	Vancouver, Canada	Dec 13, 2016	Refers to “Walk Like a Penguin” video	http://vancouversun.com/news/localnews/five-things-walk-like-a-penguin-and-other-safety-tricks-for-icy-conditions
CBC	Slippery Boots: Most Winter Footwear Fails Test of Walking on Ice	Winter footwear safety	Resource	News article	Media	Adults	Toronto, Canada	Dec 16, 2016	Lists boots that tested well and types of surfaces that are helpful - Refers to Rate my Treads website	http://www.cbc.ca/news/technology/winter-boots-tested-ice-1.3867531
Canadian Safe Step Walk-in Tub Co.	How Canadian Seniors Can Stay Safe this Winter	Winter safety advice	Resource	E-book	Business	Older adults	British Columbia, Canada	Not reported	Health care business – may be income generating	http://www.safesteptubs.ca/wp-content/uploads/2015/06/Ebook-_How_Canadian_Seniors_Can_Stay_Safe_This_Winter.pdf
Orthopaedic Therapy Clinic Inc.	Good Winter Boots are Like Good Snow Tires - But Choose Wisely	Winter footwear safety	Resource	Blog	Business	Adults	Toronto, Canada	Dec 12, 2016	Refers to Rate my Treads website	https://orthophysio.com/latest-news/osteoporosis/good-winter-boots-like-good-snow-tires-choose-wisely/
Menopaused.org	How to Prevent Falls and Fractures on Snow and Ice	Winter walking safety advice and winter safety	Resource	Blog	Business	Women in menopause	Canada	Feb 9, 2020	There are recommendations for preventing falls on snow and ice. Focus on post-menopause. May be income generating	https://menopaused.org/how-to-prevent-falls-and-fractures-on-snow-and-ice/
Complete Care Coordination	Winter Safety Tips for Seniors	Winter safety advice	Resource	Blog	Business	Older adults	Montreal, Canada	Not reported	Health care business blog – may be income generating	https://www.completecare.ca/blog/winter-safety-tips-seniors/
Women's Health Matters – Women's College Hospital	Winter Safety for Older Adults	Winter safety advice	Resource	Questions and answers format	Other – Website managed by the Women's College Hospital	Older adult women	Toronto, Canada	Feb 2011	Q&A style; Only 2 questions/answers apply to winter walking	https://www.womenshealthmatters.ca/a-question-of-health/question-of-health/all-topics/2011-questions-and-answers/winter-safety-for-older-adults
Rate My Treads	Rate My Treads	Winter footwear safety	Resource	Information	Other – Research KT	General population	Toronto, Canada	2021	Research into safe winter footwear	https://ratemytreads.com/
Caring for Aging Parents	Fall Prevention in the Elderly	Falls prevention	Resource	Blog	Other – Info curated by OTs	Caregivers	Canada	Not reported	Winter information in section 4. Outdoor hazards – small part refers to outdoors. Blog by two Occupational Therapists	https://www.caring-for-aging-parents.com/fall-prevention-in-the-elderly.html
USA
Health in Aging	Tip Sheet: Winter Safety for Older Adults	Winter safety advice	Resource	Information sheet	Non-profit	Older adults	New York, USA	July 2019		https://www.healthinaging.org/tools-and-tips/tip-sheet-winter-safety-older-adults
US and World Report News	The Older Adult's Guide to Cold Weather	Winter safety advice	Resource	News article	Media	Older adults	USA	Jan 3, 2018		https://health.usnews.com/health-care/for-better/articles/2018-01-03/the-older-adults-guide-to-cold-weather
Graying with Grace	Best Boots for the Elderly: Safer Walking in Snow and Ice	Winter footwear safety	Resource	Blog	Business	Older adults	West Virginia, USA	Not reported	From West Virginia. Health care business blog - may be income generating	https://www.grayingwithgrace.com/boots-for-the-elderly/
Senior Planning Services	Safe Winter Exercise	Safe winter exercise	Resource	Information	Business	Older adults, Caregivers	Santa Barbara, USA	Not reported	From California – Health care business – may be income generating	https://www.seniorplanningservices.com/2016/02/01/safe-winter-exercise/
Hugo Go Anywhere	Winter Walking: Winter Walking Safety Tips	Winter walking safety advice	Resource	Blog	Business	Older adults	New York, USA	Nov 2012	Health care business blog – may be income generating	http://www.hugoanywhere.com/winter-walking/

KT = knowledge translation; OT = occupational therapist.

The content of the resources focused on safety: winter walking safety advice (10 sources, 37%), winter safety advice (9 sources, 33%), both winter walking and winter safety advice (2 sources, 7%), winter footwear safety (4 sources, 15%), falls prevention (1 source, 4%), and safe winter exercise (1 source, 4%). One source additionally focused on describing a winter Nordic Pole Walking group.

Community member organizations (based in Manitoba) also commented that the resources from Canada were most relevant to the Canadian context.

Discussion

This scoping review aimed to identify outdoor winter walking programmes, interventions, and resources for older adults in grey literature to determine the extent of information available for older adults. All information sources were considered to be resources on outdoor winter walking, with the addition of one mention in a newsletter that briefly discussed a Nordic Pole Winter Walking community programme.

To assist readers in deciding which resource information may be most useful in a given situation, Table 2 was formatted to help guide a reader's decision. The table includes the “source type” as government, non-profit, media, or business to assist the reader in understanding the potential reliability of the source. Businesses are likely income generating and resources are for customer information and potentially for advertisement of the business. Users of the resources may choose information of the source type, last reported update, location (province, country), and additional notes in deciding which resources to share with clients. Some resources from other provinces or countries may be useful no matter where one is located and others may be deemed more appropriate if local.

The only walking programme identified was in a newsletter from the Active Living Coalition of Older Adults in 2011 about a Nordic Walking Group in Fort Providence, Northwest Territories, and focused on one gentleman in the group who walked no matter the weather. There was no information provided on how to set up a Nordic Walking Group.

It is important to understand what the needs and wishes of older adults are in regard to outdoor winter walking and safety considerations. Designing an outdoor walking programme in winter could have numerous potential safety issues – a possible reason why we found only one reference to an outdoor winter walking programme. However, a winter walking programme could focus on education regarding safe winter walking, indoor activities, and proper equipment and footwear, including exercises that may help limit winter slips and falls, and activities that prevent deconditioning over winter months. Winter is experienced differently in different parts of Canada – from icy hills in Vancouver, bone chilling winds in flat Winnipeg, to heavy falls of snow in the Maritimes. Programmes need to be considered (and developed) with the local context in mind.

Previous studies have identified important aspects of outdoor winter walking challenges for older adults.^11,12,24,25 Many challenges in maintaining activity and participation in winter weather have been identified by individuals post-stroke; however, strategies to continue to be active and participate also exist (e.g., finding other ways to be active indoors, and maintaining outdoor participation with social support).²⁶

Another scoping review recently conducted by this Winter Walk team included nine papers that described factors associated with outdoor winter walking for older adults.²² The review identified four areas that may act as barriers or facilitators to outdoor winter walking for older adults: adverse weather impacts, the effect of the physical environment, physical function, and the perception of environmental conditions.²² It is important to make resources available to community members that address barriers and facilitators to safe outdoor winter walking, such as concerns about slips and falls in winter and challenges with issues such as bulky clothing.²⁶ These topics were addressed in a number of the resources identified in this current scoping review.

The focus of all resources identified in this scoping review was on safety. The range of types of organizations that produced resources varied from government, non-profit organizations, businesses, and other sources. Community member consultation was beneficial in the review of the web-based information and ultimately in sharing the information broadly through community organizations. Scoping review guidelines suggest this step of community consultation.¹⁹ We were able to share results with community organizations for them to disseminate information they deemed appropriate for their members. There are multiple sources of information available from a variety of organizations and sources on the web, and individuals may benefit from being given direction to specific resources to promote uptake of available resources by older adults.

Our study has several limitations. Only English language grey literature website sources were evaluated. It is possible that sources written in other languages were missed. The grey literature search had a number of search limits as identified by the team and the study objectives. The search was also completed by multiple authors. It is likely resources exist beyond the scope of our search criteria limits. Grey literature in other formats such as paper handouts or in-person information sessions was not included.

The Google and Google Scholar searches were not completed in Incognito mode; the previous searches of the authors who searched those platforms may have influenced the search results. Google will also interpret a search based on where the search is conducted; the authors who completed the grey literature searches were based in Manitoba and Ontario.

Differences from protocol

As mentioned previously, the protocol described both academic literature and grey literature searches. This paper is focussed only on the grey literature search. Findings from the grey literature scoping review will help to inform future syntheses of grey and peer reviewed literature (e.g., identifying search terms, sources for future grey literature search).

There were some other minor differences between the review and our protocol.²¹ In the protocol we stated that we would use Google Translate for grey literature sources that were not in English. We did not encounter any sources that were not in English, based on our search criteria of the grey literature. We clarified in this paper how the grey literature selection took place and included the working definitions of programmes, interventions, and resources for our team, which were not included in the protocol. Two reviewers developed the data-charting forms, rather than three.

Conclusions

We only identified one older adult programme for outdoor winter walking in the grey literature. Perhaps this was because of the potential safety issues associated with such an intervention. Safety in outdoor winter walking is ultimately important, and all the grey literature sources focused on some aspect of winter safety. It is important that Canadian older adults are able to access resources regarding safe outdoor winter walking, and that rehabilitation professionals are aware of sources of this information, for clients who wish to walk outdoors in the winter or who have specific concerns and questions regarding outdoor winter walking.

Future work resulting from this scoping review could include the investigation of winter walking programmes focused on safe winter walking education and indoor exercise activities that may help limit deconditioning and slips and falls outdoors in winter.

Key Messages

What is already known on this topic

There are many challenges to outdoor winter walking for older adults related to internal and external factors, such as safety concerns and weather.

What this study adds

There are web-based resources available that focus on safety in outdoor winter walking for older adults. Resources are posted by a number of different organizations and may be difficult to find.

While web-based resources that focus on safety in outdoor winter walking for older adults were identified, only one outdoor winter walking programme was identified.

Rehabilitation professionals may use web-based information on outdoor winter walking safety to assist clients who are interested in outdoor winter walking and have questions or safety concerns.