The Effects of Inclined Treadmill Walking on Fall Risk Prevention and Well-being in Older Adults: A Narrative and Systematic Review
Falls among the elderly population are an ongoing concern. Falls lead to reduced independence, increased rates of mortality and disability, and diminished well-being and quality of life. Physical activity has been recognized as an effective approach to minimising fall risk in this population. However, the risk of falling itself can act as a deterrent to physical activity, exacerbating the problem. Limited knowledge exists regarding the effectiveness of inclined treadmill walking in older adults. This training modality has the potential to improve lower extremity strength and flexibility in older adults, as found in the promising outcomes in younger adults. This dissertation aimed to explore the impact of inclined walking on the well-being and quality of life of the elderly population. A comprehensive approach was used, comprising both a narrative review and a systematic review. The narrative review used nine articles, while the systematic review included six articles, with one article overlapping between the two. The narrative review used a broad literature search process focusing on walking, inclined walking, or the population of the elderly as the core search terms to build a comprehensive understanding of the topic. The systematic review followed PRISMA guidelines, utilizing a flow diagram for article screening and selection, and both reviews used a literature table to assist in synthesis purposes. Acute studies of inclined treadmill walking formed most of the literature over training studies due to the scarcity of the literature. The results indicated that flat-surface treadmill walking has a significant positive effect on well-being and quality of life among the elderly. Preliminary findings suggest that inclined walking also has a positive impact; however, the scarcity of literature necessitates further research on this topic. Positive results were noted through monitored nutrition, with an increased consumption of astaxanthin paired with inclined walking increasing postural control and strength measures. On the other hand, older adults were observed to have decreased muscle strength, impaired balance, and compensatory movements when inclined walking, and significantly increased fall risk at 70+ years. Older adults showed increased hip and decreased ankle joint work with decrease in ankle joint peak extensor moments and less peak power, and increased hip joint peak power compared to younger adults. The findings highlighted a linear increase in fall risk with advancing age during inclined walking, emphasizing the need for heightened safety measures as individuals grow older, a limitation to this training within this population.