By Kelly K. Veit, DPT
Walking is often something that we take for granted. Standing up and moving is not an activity most people think about, we just do it. There are many components that work in harmony to allow a person to walk safely. As we shift our weight side to side and move forward across space and time, we are actually just having a series of controlled falls. Muscles and neurological systems work simultaneously to keep us going. But when illness or injury occurs that affects walking, it can be devastating to a person and their livelihood. There can be a decrease of strength, loss of balance, a slowing of their speed, a shortening of their step, and a decline of their daily activities.
Research has shown that walking speed should be considered a 6th vital sign and is a good indicator of future outcomes in mobility (Middleton et al., 2015). Walking speed is a combination of stride length, strength, and balance control. The scholarly review article written by Middleton et al. (2015) summarized research findings about walking speed and its prediction ability regarding mobility in the community and at home. Individuals that walk greater than 0.8 meter/second are safe to walk in the community and are less likely to be hospitalized. For those that have a walking speed of less than 0.8 meter/second they have an increased risk of falls, cognitive decline, hospitalization, and death. A decline in walking speed can have serious consequences for a person’s future. It’s important to notice if there are changes in a family member’s walking and to determine why it is happening. One main reason is weakness.
Weakness is well known in the research to cause difficulty with walking. Weakness can occur for many reasons, aging and injury are two. If we don’t use our muscles, we start to lose them. As we age muscle mass declines 1% a year, but muscle strength declines faster at 2-4% per year (Lavin et al., 2019). This loss of mass and strength can lead to reduced balance and may in turn reduce walking speed and frequency. It is well documented that exercises with resistance can have a positive effect on the loss of muscle mass and strength. Lavin et al., (2019) further find in their research that moderate resistive exercise training can improve leg strength 25-35% in just 8-12 weeks and that it has a significant effect on balance, reduced fall risk, and reduced mortality in elderly. By causing an overload to the muscle using weights, improvements in power and strength will occur. The evidence also suggests that after 8 weeks of stopping a training program, there is loss of strength (Lavin et al., 2019). It’s important to keep exercising! In addition to strength training having positive results, Avers and Brown (2009) found that functional training also has a positive effect and that utilizing training in a specific activity for those that are very weak has shown to be helpful. For example, if a person has trouble standing up from a favorite chair, the action can be modified or broken down into easier tasks to then meet the goal as the person becomes stronger.
The research is clear. Improving muscle mass and muscle strength will improve mobility. Improving mobility can improve walking speed. Improved walking speed is proven to prevent falls, decrease risk of hospitalization, and can improve independence in your life. Resistance training and exercises specific to the activities that hinder you are exactly what Tandem Strength and Balance focuses on. Our individualized programs are made to improve your strength, keep you strong, and keep you walking.
- Avers, D. & Brown, M. (2009). White Paper: Strength Training for the Older Adult. Journal for Geriatric Physical Therapy, 32(4), 148-152.
- Lavin, K et al., (2019). The Importance of Resistance Exercise Training to Combat Neuromuscular Aging. Physiology, 34(2), 112-122. https://doi.org/10.1152/physiol.00044.2018
- Middleton, A., Fritz, S. L., & Lusardi, M. (2015). Walking speed: the functional vital sign. Journal of aging and physical activity, 23(2), 314–322. https://doi.org/10.1123/japa.2013-0236<./li>