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The Treadmill Is Your Friend
by Christy Bailey
There is growing evidence that the brain can relearn basic walking skills, even years after a stroke. And when it comes to walking, the treadmill may be the handiest tool you can have in your stroke recovery toolkit.
A treadmill provides controlled, repetitive motion that cannot be matched by outdoor walking. This is especially important for stroke survivors, who are trying to retrain their brains through repetition. The more they can repeat the same exact motion over and over again, the more likely that their brains will relearn how to do it.
"The treadmill helps more than other exercise routines because the treadmill directly interacts with the foot and leg," said researcher Richard Macko, M.D. "The repetitive motion of the treadmill belt and the ability to increase intensity level retrains the body to walk more efficiently."
Research backs this up. Over the past 10 years, several studies have shown that treadmill training can improve how well stroke survivors walk. In one by Macko and his colleagues, participants who did progressively difficult, frequent treadmill sessions over a six-month period improved their walking ability more than those who did shorter treadmill walking sessions combined with stretching.
In addition, treadmills can provide external support to those who don't have the necessary balance to walk on their own. That's because handrails and harnesses can be used to keep users upright. In a 2001 study, Macko and a team of researchers showed that six months of treadmill training with handrail support improved walking efficiency and leg strength among participating stroke survivors.
Body weight-supported treadmill training BWSTT is also helping stroke survivors. This involves suspending a patient from an overhead lift and assisting the legs to step. The support has two benefits. Patients won't fall because a harness keeps them upright. They also have less weight to bear because the harness system is sharing the burden. Studies have shown that improvements in walking speed during BWSTT sessions also transfer to walking speed on the ground.
A University of Delaware UD study is taking treadmill training one step further. Funded by the National Institutes of Health, the study is helping stroke survivors learn to walk without a limp by using a split-belt treadmill. This novel treadmill uses two belts, with each leg moved at a different speed. Initial findings showed improved leg coordination - at least temporarily. More research is being done to determine long-term effects.
To find out if there are any treadmill training studies in your area, go to http://www.clinicaltrials.gov/. But don't get discouraged if you don't find anything to help you right now. Advancements are being made in this area each year, and chances are that some sort of treadmill training may be part of your future.
For more information on this topic, go to www.stroke.org/strokesmart and check out archived issues of the magazine. To learn how treadmills are being paired with robots to help stroke survivors improve their walking ability, read the March/April 2007 Rehab story. To learn more about Macko's treadmill studies in more detail, read the January/February 2006 News You Can Use and the March/April 2007 Mobility story.
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