It is well established that exercise improves the balance of older people, specifically an exercise programme which includes both strength and aerobic training. The aerobic element can be difficult to dose and decide on which exercise to use, for most people the go to piece of equipment is a treadmill.

Oftentime older people with balance defecits would never have been on a treadmill before and find the thought terrifying which prevents its use. Additionally the fear is often shared with the physio as it’s common to think that older people will just fall off of a treadmill the moment the physio moves a few metres away or turn their backs.

A non-blinded non-randomized trial published in the Journal of Aging Research has investigated how effective treadmill training is for improving postural balance for over 65’s in long-term care facilities. The study involved 30 in the intervention group and 25 in the control group. The control group were comprised of those who had declined the intervention and continued their normal activites. Those in the intervention consisted of training on the treadmill twice a week with intervals of 2 and 3 days, in sessions of up to 40 minutes over a period by 10 consecutive weeks.

Prior to the intervention a 10MWT was performed to establish an outcome measure but this speed was used to direct the speed of the treadmill during the sessions. The BERG, SPPBS and TUG were all also used to assess mobility and balance. The 10MWT was used to set the pace fof the intervention with bursts of speed above the participants walking speed were used as the mian treatment.

Clinical Importance

There were improvements in all outcome measures for the intervention group which persisted even after a month after the intervention. There was a whopping 0.21m/s average increase in gait speed as a result of the intervention. This is massively significant as gait speed is a reliable and valid measure of overall balance and abilities in this age group. Similar studies report about 6% less of an imporvement than this intervention.