This is part of our on-going series of exploring neurological and degenerative conditions that can affect a number of individuals and specifically how Physical Therapy can help”
Today’s topic is about the benefits of using a treadmill and a few different activities to incorporate into this activity. As a clinician side I love using the treadmill for my clients who are faced with various neurological impairments that specifically affect their ability to walk. I use the treadmill with patients who have had a stroke, spinal cord injury or are faced with challenges from living with multiple sclerosis, Parkinson’s, degenerative conditions and/or developmental delays from childhood.
If you have on of these conditions of something along similar lines and have difficulty walking then likely you are asymmetrical in your walking pattern. Some characteristics of a challenging gait are reduced stride, decrease cadence, decrease velocity, wider or narrow base of support, longer periods of time spent in double stance, and greater deviation with your swinging leg. Also, generally the energy cost on walking is greater with more deviations so many times it is simply easier to not walk for some people.
In theme with the neuroplasticity topic that we keep addressing, the treadmill is task specific and repetitive which are key to making new connections. The treadmill can allow for higher intensities of walking practice which is due to the increase repetitions leading to overall better outcomes down the road. Using the treadmill also can promote improved cardiovascular health.
The treadmill can be used alone with full body weight support or there are certain devices used by physical therapists and rehab facilities that are called body weight support. These devices can be anything from a gravity eliminated treadmill to harness that use lift systems to provide less body weight during walking and more assistance to the person doing the training. Overall, body weight supported treadmill training can make it easier to walk, decreases fear for the client and allows the therapists to assist where assist is needed thus working on proper patterns and technique. This intense training can then be carried over to overground walking and the results can be promising with decease asymmetries and improved efficiency when walking in the community. Body weight support treadmills are usually found in rehabilitation clinics and are best used with a trained clinician.
Certainly, not everyone needs a body weight supported treadmill system to gain benefits. If you are safe, stable and have supervision then a lot of times we can use the treadmill as is. The rhythmic, repetitive nature of the treadmill is what helps with improving gait asymmetries. You always want to start out with a comfortable speed and increase as tolerable and as long as you maintain a proper gait pattern. We tend to think that faster is better but this is not always the case with treadmill training. Other things you can try on the treadmill are walking sideways and walking backwards as these manners help to train the brain in other areas and add a little challenge to the coordination piece as well as strengthening different muscles and improving coordination.
Everyone is different in terms of endurance, safety, original impairments but if you can perform at least 3 to 5 days of concentrated bouts of treadmill training for >15 to 30 minutes a time then there may be progress in 12 weeks. Like anything it is best to continue a regular routine.
The benefits are too good not try using the treadmill to help in your recovery.