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Summary on Elderly & Treadmills

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  • Summary on Elderly & Treadmills

    Thanks to those who replied to my query. My original post and all the
    replies follow:

    From: Vernon McDonald
    Dear All,

    I am interested in hearing opinions on the use of treadmills in the study
    of elderly walking. I am sensitive to the general issues surrounding
    treadmill vs overground walking, but I would like to hear first hand from
    those investigators who have had elderly subjects walking on a treadmill.

    Specifically, are there issues unique to this population that need to be
    taken into account? For example, is there a need for a long habituation
    time? Are unsteady individuals somewhat fearful of the treadmill? How
    have human research review boards responded to this combination?

    Any information regarding special procedural accomodations that need to be
    taken in having the elderly perform treadmill walking (and running?) would
    be very much appreciated.

    From: Phil Martin

    We have had healthy "young old" adults (about 65-75 yrs of age) walking
    on the treadmill under a number of speed and stride length/cadence
    conditions (e.g., Martin, Rothstein, Larish, 1992, Journal of Applied
    Physiology 73: 200-206) without complication. Based on previously
    published research on treadmill accommodation, we routinely accommodate
    both young and old novice treadmill walkers at least 30 minutes (usually
    in three 10-min bouts) prior to biomechanical or physiological data
    collection. VO2 data from the JAP publication, however, suggested that
    a subtle accommodation process as reflected by a small decrease in VO2
    for a given walking speed occurred after our 30 minutes of treadmill
    practice. You may wish to consider accommodating your subjects somewhat
    longer than our 30 minutes. When accommodating our subjects, we
    generally assumed that the potential for a fall was greater for the old
    than young subjects. Thus, we spent more time providing instruction and
    demonstrations for them, always had someone standing immediately behind
    them when they first stepped onto the treadmill, and started with lower
    speeds than with our younger subjects. Subjectively, we observed no
    major differences between young and old in the progression of their

    From: (Dieter Rosenbaum)

    I have not personally investigated elderly on a treadmill but
    read a comparative investigation between treadmill and overground
    running that also used middle aged subjects (around 40-50 year).
    One result was a more inclined upper body and head angle probably
    due to the subjects looking down on the treadmill and not ahead
    as in normal walking. Furthermore, form my own experience with
    recreational runners on a treamill you should take enough time for
    getting them used to the experimental situation. Based on the problems
    that even younger people with normal coordination revealed you should
    be well aware of the potential implications of the treadmill use.
    (shorter steps, leaning forward, trying to push the belt, ...)
    Besides allowing for ample accomodation the treadmill should be wide
    enough to allow for slight lateral deviations (around 80 cm width),
    have a safety belt to prevent falling when the subjacts stumble, have a
    rail for mechanical and "psychological" support. It also helps to
    visually inspect the subject`s overground gait before they step on
    the treadmill in order to get an idea of what movement pattern to look
    for on the treadmill.
    I am sorry that I cannot provide any hard data but maybe this still helps.

    From: (Michael Schauer)

    We published a study in the Nov. issue of Arch.Phys. Med. Rehabil. about
    treadmill training in stroke patients. (Hesse et. al., unfortunatly I
    have the copy in the hospital and not avialable at home). Patients, who
    included elderly stroke patients were supported in a parachute harness.
    For very old people the methods is not very suitable, therefore we
    omitted them from the study. The method was very effective to retrain
    gait functions in hemiplegics.

    Dr. Karl-Heinz Mauritz
    Klinik Berlin
    and Dept. Neurological Rehabilitation
    Free University Berlin
    Kladower Damm 223
    D-14089 Berlin

    From: "James C. Wall"
    Vernon - You might wish to look at the following:

    Wall, J.C. and Charteris, J. The process of habituation to treadmill
    walking at different velocities. Ergonomics. 23: 425-435, 1980

    Wall, J.C. and Charteris, J. A kinematic study of long term habituation
    to treadmill walking. Ergonomics. 24: 531-542, 1981

    Regards, Jim Wall.
    Date: 15 Dec 94 10:04:54 EST

    From: Dan Fuglewicz

    Dear Vernon:

    In the initial work with our new Gaitway treadmill, we found individuals who had
    little or no experience with treadmills required five minutes to acclimate. For
    elderly patients, I imagin the time to acclimate would be longer though I have
    no actual experience. We have found initial belt speed, height of treadmill bed,
    support apparatus and abort controls to be key issues to the elderly's ability
    to adapt and their recepiveness.

    Good Luck!


    __________________________________________________ ______________
    Vernon McDonald Motor Performance Lab.
    KRUG Life Sciences NASA/Johnson Space Center
    __________________________________________________ ______________