In last week’s post we talked about weight shifting and trunk elongation to help walking quality and energy efficiency. This week we are going to look at using a treadmill.
For some kids who are working on walking quality and efficiency foot placement can be a big deal. How they take that first step can affect everything else that goes up the chain to the hips, the trunk, and the head. By using a treadmill you can slow down the speed so they have time to think about what they are doing and get in a lot of practice and repetition (remember: repeat, repeat, repeat…). We also added tape down the middle to help provide a visual cue for foot placement to help decrease scissor stepping (when feet cross over midline while walking instead of going straight in front).
We also provided a wooden dowel in front to provide some balance assist (but with only 1-2 fingers resting lightly so they aren’t leaning on it). With some verbal cues for heel to toe foot placement, and the light support at the wooden dowel to help keep the trunk upright, it also helps to prevent other compensations that can occur from underlying hip weakness such as internal rotation at the hip to lock out the joint and create stability. But it also creates a crouching pattern that decreases efficiency and energy conservation with walking.
We are lucky enough to have access to a treadmill that can start at really low speeds. We did 2-3 minute increments of walking, over 4 different speeds, twice at each speed. As we were building up occasional manual cues were provided to assist with weight shifting, as well as pelvic and trunk rotation. After we got up to the highest speed we were going to, we went back down to the slowest, and repeated 2 sets at that speed without any manual cues. Afterwards, we went to overland walking. Since it still isn’t automatic (remember it takes lots of repetition to make it automatic) there were lots of verbal cues to slow down the walking rather than go back into the habitual walking pattern that automatically arises when they aren’t thinking about each step they take.
How have you guys used a treadmill to help walking quality?