Why is gait health important for overall health?
It’s been said that walking is our superpower. We often take it for granted until something goes amiss. Walking requires complex, rhythmic, patterning, moving in cyclical stages, taking years to develop. The first stage starts when we begin to crawl. Humans walk reciprocally, meaning that the right leg moves forward, as the left shoulder/arm moves forward. when our left leg moves forward, our right shoulder/arm moves forward. We traditionally walk independent by the age of 11-15 months; taking our first steps with a wide stance, broad base of support and arms outstretched. By 3-4 years old, our gait is considered mature.
Unfortunately, our bodies start to gradually deteriorate around age 30. Gait is affected by gravity, injuries, deconditioning, emotional and physical trauma and continues to decline as we age. Vestibular, neurological, degenerative, and many other conditions lead to gait impairment. This article will focus on vestibular disorders and how these disorders impact our gait health.
Our vestibular system controls our balance and walking, as well as modulates our gait. When our control and balance in walking become impaired, we begin taking longer, slower steps while walking at normal speed. When our gait modulation is impaired, our typical gait cycle timing declines, while we try to improve our postural control.
Our gait speed is an integrative way to measure overall health. Gait alterations can influence the function of multiple physiological systems (see figure 1) Our gait predicts disability and mortality risk. Every 0.1m/s slower we walk; we have a 30% increased risk of disability to occur within 3 years. Every 0.1m/s slower we walk; we have a 18-24% increased risk of mortality to occur within 4 years.
Figure 1: Gait is integrated with our physiological systems and impairment can lead to falls, frailty, loss of independence, and death.
What does this mean for a person living with a vestibular disorder?
Falls are the leading cause of injury for older adults and for those with a chronic medical condition. Vestibular related gait changes lead to an increased risk of falls. There is a decrease in motor unit recruitment, nerve conduction velocity, and cross section muscular fibers. This leads to decreasing sensory input at certain joints leading to improper neuromuscular control causing a negative change in balance. These changes may cause decreased gait speeds and increased variability in stance (balancing on one foot while shifting weight) and swing (phase of advancing the leg following toe push off) time. All of these changes lead to loss of confidence and an overall increase in risk of falling or stumbling.
Every year one in four adults fall, leading to 3 million emergency department visits and 800,000 hospitalizations. When a person falls, there is an increased risk for death by 30%. Our Center for Medicare and Medicaid Services pays 75% of these costs related to falls. The total costs for falls in 2015 were $50 billion; which are predicted at over $101 billion in 2030. We want to be a part of the solution and decrease fall risks; to allow people to age in place and thrive at home.
We have three inherent fall risk mechanisms including visual, vestibular (inner ear/balance), and somatosensory that all work together. Our somatosensory system includes our sensations like pain, touch, pressure, and sight, allowing us to navigate in varied environments like icy surfaces, cobblestones, sand, carpet, hallways or crowded sidewalks. When these three systems optimally work together, it increases the speed at which we react to a potential fall, therefore decreasing our risk of falling. Training these three systems together can lead to a decrease in fall risk.
What does Vizziq do? How can it help a vestibular warrior?
Vizziq Neuromuscular Trainer is a novel, patented, over-the-ground neuromuscular gait training device that is designed to be used both in the clinic and at home. Vizziq has a spring-loaded, surround-around, progressive pivoting frame that can be locked (non-pivoting) or unlocked (pivoting) based on the goals and functionality of the user. The pivoting frame allows for trunk and pelvic rotation that would otherwise be compromised by other mobility devices. Vizziq is the only mobility device that syncs with your stride and promotes independence, not dependance.
Vizziq has two hand placements including upright and parallel bar placements. The upright hand placement allows for forward gaze, decreasing the traditional (kyphotic) stoop-over and shuffle posture. The parallel bar placement can be used by individuals requiring additional support. Additionally, adding weights to the frame can improve stability, maneuverability.
Vizziq engages all three inherent fall defense mechanisms (visual, vestibular, somatosensory) simultaneously. Repetition is the key to motor learning and Vizziq provides the repetition necessary to improve gait health.
How do I train with Vizziq?
Evidence suggests Vizziq training for a minimum of 20 minutes, 3 times a week, improved gait mechanics like gait speed, stride length, trunk & pelvic rotation, posture, balance, confidence, and decreased the fear of falling. Vizziq walks with you, mirroring your gait and may correct imbalances with prolonged use.
Vizziq also converts to a personal exercise station. Once the wheels and frame are locked down, it’s a 3-dimentional frame. to stabilize and align while performing specific vestibular, strengthening, flexibility and range of motion exercises. Weights and resistance bands may be fastened to the frame to provide stability and dynamic strengthening.
We are excited to introduce Vizziq Training as a method of walking better vs. declining. Ask your healthcare provider about walking stronger for longer. Join The MOVEMENT Movement and begin walking right again. For more information, visit vizziq.com.
Making Vestibular Visible
Watch an interview with Vizziq inventor, Katherine Haik, where she describes her inspiration for developing this novel gait trainer and shares how it has helped her and others regain confidence while walking.