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Updated 3:00 PM November 15, 2007




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People re-learn to walk, balance more quickly without handrails

New research from U-M suggests that people re-learning how to balance while walking will benefit more if they practice without handrails or other assistance.

Division of Kinesiology researchers set out to test the idea that physical assistance can improve walking balance by having healthy subjects learn to walk on a narrow balance beam.

Researchers found healthy subjects had greater improvements in performance, however, when they practiced the task without holding handrails than when they practiced while holding them. The findings challenge the conventional method of physical therapy, where therapists physically assist patients who are trying to re-learn to walk after injury. This type of assistance is akin to putting training wheels on a bike when a child learns to ride.

"These findings will help determine the ideal way to use physical assistance in therapy settings and also be helpful in designing robotic devices used for rehabilitation," says Antoinette Domingo, physical therapist and doctoral student who led the study. Domingo works in the lab of Daniel Ferris, associate professor of kinesiology.

During testing, the subjects who practiced beam walking without using handrails were able to stay on the beam 27 percent longer after training. Subjects who constantly touched the handrails during practice only had a 15-percent improvement and subjects who used the handrails only as needed had a 16-percent improvement in time walking on the beam.

Possible drawbacks to physical assistance are that it alters the fundamental movement dynamics and does not allow learners to make mistakes, which is essential to learning how to prevent them in the future when it comes to motor skills, the researchers say.

In the experiments, three groups of seven healthy subjects walked at a slow pace on a narrow balance beam that was mounted on a treadmill (beam-mill). Healthy subjects were studied to establish basic principles of learning balance with the intent to extend these principles to relevant patient populations in future studies.

The first group practiced without using handrails at all, the second group used constant assistance by holding handrails throughout training, and the third group practiced by using the handrails only as much as the subjects felt they needed to learn to walk on the beam.

Subjects were evaluated during five minutes of unassisted walking on the beam-mill before and after 30 minutes of practice. Researchers measured the length of time subjects were able to stay on the beam and the magnitude of side-to-side movement of the hips while the subjects walked on the beam before and after training. Then the team compared performances to see how much each subject improved.

The no-handrails group had a greater improvement in the length of time they were able to walk on the beam-mill than both the constant handrails group and the as-needed group. The magnitude of side-to-side movement of the hips while walking on the beam, however, was not a good indicator of the time that subjects could stay on the beam. It is likely that the no-handrails group was more aware of the limits of its balance because it experienced more movement without falling off the beam.

The paper, "The effects of physical assistance on motor learning of narrow beam walking," was presented Nov. 3 at Neuroscience 2007, the annual meeting of the Society for Neuroscience.

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