Treadmill walking improves walking speed and distance in ambulatory people after stroke and is not inferior to overground walking: a systematic review

Although lower limb strength becomes asymmetrical with age, past studies of aging effects on gait biomechanics have usually analyzed only one limb. This experiment measured how aging and treadmill surface influenced both dominant and nondominant step parameters in older (mean 74.0 y) and young participants (mean 21.9 y). Step-cycle parameters were obtained from 3-dimensional position/time data during preferred-speed walking for 40 trials along a 10 m walkway and for 10 minutes of treadmill walking. Walking speed (young 1.23 m/s, older 1.24 m/s) and step velocity for the two age groups were similar in overground walking but older adults showed significantly slower walking speed (young 1.26 m/s, older 1.05 m/s) and step velocity on the treadmill due to reduced step length and prolonged step time. Older adults had shorter step length than young adults and both groups reduced step length on the treadmill. Step velocity and length of older adults’ dominant limb was asymmetrically larger. Older adults increased the proportion of double support in step time when treadmill walking. This adaptation combined with reduced step velocity and length may preserve balance. The results suggest that bilateral analyses should be employed to accurately describe asymmetric features of gait especially for older adults.

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Changes in Spatiotemporal Measures and Variability During User-Driven Treadmill, Fixed-Speed Treadmill, and Overground Walking in Young Adults: A Pilot Study

Journal of Applied Biomechanics ◽

10.1123/jab.2020-0109 ◽

2021 ◽

pp. 1-5

Author(s):

Hillary H. Holmes ◽

Randall T. Fawcett ◽

Jaimie A. Roper

Keyword(s):

Young Adults ◽

Motor Control ◽

Pilot Study ◽

Human Health ◽

Gait Cycle ◽

Walking Speed ◽

Treadmill Walking ◽

Overground Walking ◽

Control Patterns ◽

Integral Indicator

Walking is an integral indicator of human health commonly investigated while walking overground and with the use of a treadmill. Unlike fixed-speed treadmills, overground walking is dependent on the preferred walking speed under the individuals’ control. Thus, user-driven treadmills may have the ability to better simulate the characteristics of overground walking. This pilot study is the first investigation to compare a user-driven treadmill, a fixed-speed treadmill, and overground walking to understand differences in variability and mean spatiotemporal measures across walking environments. Participants walked fastest overground compared to both fixed and user-driven treadmill conditions. However, gait cycle speed variability in the fixed-speed treadmill condition was significantly lower than the user-driven and overground conditions, with no significant differences present between overground and user-driven treadmill walking. The lack of differences in variability between the user-driven treadmill and overground walking may indicate that the user-driven treadmill can better simulate the variability of overground walking, potentially leading to more natural adaptation and motor control patterns of walking.

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The Relationship Between Walking Speed and the Energetic Cost of Walking in Persons With Multiple Sclerosis and Healthy Controls: A Systematic Review

Neurorehabilitation and Neural Repair ◽

10.1177/15459683211005028 ◽

2021 ◽

pp. 154596832110050

Author(s):

Kyra Theunissen ◽

Guy Plasqui ◽

Annelies Boonen ◽

Bente Brauwers ◽

Annick Timmermans ◽

...

Keyword(s):

Multiple Sclerosis ◽

Healthy Subjects ◽

Walking Speed ◽

Included Study ◽

Treadmill Walking ◽

Energetic Cost ◽

Overground Walking ◽

Blood Institute ◽

National Heart Lung ◽

The Relationship

Background Persons with multiple sclerosis (pwMS) experience walking impairments, characterized by decreased walking speeds. In healthy subjects, the self-selected walking speed is the energetically most optimal. In pwMS, the energetically most optimal walking speed remains underexposed. Therefore, this review aimed to determine the relationship between walking speed and energetic cost of walking (Cw) in pwMS, compared with healthy subjects, thereby assessing the walking speed with the lowest energetic cost. As it is unclear whether the Cw in pwMS differs between overground and treadmill walking, as reported in healthy subjects, a second review aim was to compare both conditions. Method PubMed and Web of Science were systematically searched. Studies assessing pwMS, reporting walking speed (converted to meters per second), and reporting oxygen consumption were included. Study quality was assessed with a modified National Heart, Lung and Blood Institute checklist. The relationship between Cw and walking speed was calculated with a second-order polynomial function and compared between groups and conditions. Results Twenty-nine studies were included (n = 1535 pwMS) of which 8 included healthy subjects (n = 179 healthy subjects). PwMS showed a similar energetically most optimal walking speed of 1.44 m/s with a Cw of 0.16, compared with 0.14 mL O2/kg/m in healthy subjects. The most optimal walking speed in treadmill was 1.48 m/s, compared with 1.28 m/s in overground walking with a similar Cw. Conclusion Overall, the Cw is elevated in pwMS but with a similar energetically most optimal walking speed, compared with healthy subjects. Treadmill walking showed a similar most optimal Cw but a higher speed, compared with overground walking.

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Is treadmill walking biomechanically comparable to overground walking? A systematic review

Gait & Posture ◽

10.1016/j.gaitpost.2021.11.009 ◽

2021 ◽

Author(s):

Marie B. Semaan ◽

Laura Wallard ◽

Valentin Ruiz ◽

Christophe Gillet ◽

Sébastien Leteneur ◽

...

Keyword(s):

Systematic Review ◽

Treadmill Walking ◽

Overground Walking

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Metabolic cost in healthy fit older adults and young adults during overground and treadmill walking

European Journal of Applied Physiology ◽

10.1007/s00421-021-04740-2 ◽

2021 ◽

Author(s):

Sauvik Das Gupta ◽

Maarten Bobbert ◽

Herre Faber ◽

Dinant Kistemaker

Keyword(s):

Older Adults ◽

Young Adults ◽

Walking Speed ◽

Metabolic Cost ◽

Treadmill Walking ◽

Afternoon Session ◽

Overground Walking ◽

Age Related ◽

Long Time ◽

Per Se

Abstract Purpose The purpose of this study was to determine whether net metabolic cost of walking is affected by age per se. Methods We selected 10 healthy, active older adults (mean age 75 years) and 10 young adults (mean age 26 years), and determined their preferred overground walking speed. On the same day, in a morning and afternoon session, we had them walk at that speed overground and on a treadmill while we measured oxygen consumption rate. From the latter we subtracted the rate in sitting and calculated net metabolic cost. Results Anthropometrics were not different between the groups nor was preferred walking speed (1.27 m s−1 both groups). There was no difference in net metabolic cost of overground walking between older and young adults (e.g., in the morning 2.64 and 2.56 J kg−1 m−1, respectively, p > 0.05). In the morning session, net metabolic cost of walking was higher on the treadmill than overground in our older adults by 0.6 J kg−1 m−1 (p < 0.05), but not in young adults. Conclusion First, there is no effect of age per se on metabolic cost of overground walking. Second, older adults tend to have higher metabolic cost of walking on a treadmill than walking overground at preferred speed, and adaptation may take a long time. The commonly reported age-related elevation of metabolic cost of walking may be due to confounding factors causing preferred walking speed to be lower in older adults, and/or due to older adults reacting differently to treadmill walking than young adults.

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