Thanks to those who replied to my query. My original post and all the
replies follow:
ORIGINAL POST:
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.
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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
accommodation.
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From: diro@sirius.medizin.uni-ulm.de (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.
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From: rehaklin@fub46.zedat.fu-berlin.de (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
rehaklin@zedat.fu-berlin.de
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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
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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!
Bob
__________________________________________________ ______________
Vernon McDonald Motor Performance Lab.
KRUG Life Sciences NASA/Johnson Space Center
vmcdonald@plato.jsc.nasa.gov
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