Rewire Your Brain One Step on a Treadmill at a Time

Walk This Way

From the article "walk This Way" by Amy Paturel, M.S., M.P.H. Copyright © 2010 Neurology Now. Published by Lippincott Williams & Wilkins.

Treadmill and task-oriented training have been shown to mobilize people with stroke, Parkinson’s, and other neurological diseases that impact gait. But it’s not all as simple as that.

Richard Macko, M.D., professor of neurology at the University of Maryland and director of the Veteran Affairs (VA) Rehabilitiation Research and Development Center of Excellence in Exercise and Robotics, explains in the article “Walk This Way” by May Paturel, M.S., M.P.H., in the May/June 2010 issue of Neurology Now, explains:

One of the main problems with stroke is that people get these motor deficits that cause them to lose their functional independence…There’s a 70 percent fall rate within the first year of stroke. Plus, fitness levels are half normal and the energy cost of walking for stroke patients is about double that of people who haven’t suffered a stroke because of abnormal nervous system connections. And that’s a bad combination. (p. 23-24)

But stroke patients aren’t the only people to suffer problems with gait. As the article continues to explain, problems with and balance are pervasive across neurological disease.

As Paturel explains, walking is actually a very complex task that requires an integration of multiple systems in the body. The task of walking is so complex that Dr. Jessie VanSwearingen, Ph.D., P.T. even likens walking to a sixth sense. This level of complexity means that if there is a disruption to any of the centers that are related to processing information coming into the brain (i.e. where your foot is in relations to space or the body) or the centers responsible for sending commands back out from the brain (i.e. “lift your foot”), your ability to walk with become greatly compromised (p. 24).

But as Lisa Schulman, M.D., professor of neurology at the University of Maryland and co-director of the Maryland Parkinson’s Disease and Movement Disorders Center, argues, the medical world often overlooks the nonpharmacological interventions like exercise, in favor of prescribing medications that have shown to have an improving effect on neurological disorders, but more often than not cause more problems with gait than alleviates them. As Schulman argues, “…nonpharmacological interventions like excercise…reinforce the patient’s need to feel in control and may sometimes even have more potent effects than conventional pharmacological therapies” (p. 24).

The remainder of the article describes in detail Dr. Macko’s treadmill and task-oriented training, how the regimine is applied and how this regimine is more effective on neurological problems of gait than traditional pharmacolical therapies. In truth, the regimine all sounds so simple in application that its a bit baffling why this therapy isn’t applied more often. But with knowledge comes power and with that comes a stronger ability to self-advocate for you or a loved one who may need treatment for problems of gait.

The article isn’t very long; in fact, this post summarized the whol first half of the article, all you need read is the sections Treadmill Training and Task-oriented Training for information on Dr. Macko’s treatment. The article can be read in the May/June 2010 (Vol. 6 Iss. 3) issue of Neurology Now; subscription is free. You can also read the published online version here. The page also provides a link for a printable PDF version of the article. The article also gives you 10 quick tips to get you moving if you have problems walking and often lose your balance, or is you are out of shape and get winded quickly.

Related: Paturel, M.S., M.P.H., Amy. “Walk This Way.” Neurology Now May/June 6.3 (2010): 23-25. Print.

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