Today I did something unusual. I left early. It’s near the end of the semester. This is the time of year when everything is due at once, but it is also the time of year when the sun comes out for the first time in months. I looked out the window at the blue sky and I decided that the PowerPoint I was making could wait. So I went for a walk. I followed a surprisingly empty bike path near the river. I successfully passed by two joggers, one biker, and an entire women’s rowing team without having to talk to anyone. I brought my camera along and got a few pictures of the evidence that spring is spreading.

As I walked, my mind kept returning to the presentation that I had been putting together, which was on the topic of gait and balance. I have been fascinated by the way people stand and walk ever since I was a kid, this interest is what got me into sports medicine, and then into the field of orthotics and prosthetics and now into my PhD research. This semester, I am collecting data on a project that measures people’s balance when they are standing in various conditions. I am also the TA for an undergraduate biomechanics class. The presentation I am putting together is for a class lecture that will hopefully help the students think about ways to apply their newly acquired understanding of biomechanics to their future careers in rehabilitation science. I thought talking about walking would a good way to do this.

I just want to be able to walk  ________”  Fill in the blank.  Some patients say again, some say without pain, some say for the first time, or down the aisle at my wedding, to the mailbox, or up a mountain. I have heard variations of that sentence hundreds of times. For many people, the line between disability and normality is drawn at the ability to walk. If walking is unavailable, we will settle for alternate forms of transport – like wheelchairs or mobility scooters. But walking does seem to be the preferred method. Last year I had the opportunity to participate in a research project about mobility of the elderly within the home environment. We interviewed the participants about how well they were able they were to move around their homes, we measured their walking ability and we measured their homes. Mobility is a result of two different factors – the person’s physical abilities and the challenge of their environment. This becomes clear if you consider two extreme scenarios:

1)   A rock climber can use his extraordinary fitness and skill to conquer a cliff face.

Mobility2

2) An old woman uses all of her strength to reach the top of a flight of stairs.

mobility3

The amount of effort might be similar in both situations. In both cases, the individual is pushed to the limit to overcome a barrier. The only differences are the size of the barrier, and the extent of the physical limitations. This afternoon as I was walking along a smoothly paved bike path, I was well within my mobility “comfort zone”. I was able to enjoy the scenery and let my mind wander without having to struggle through each step. It’s a privilege to be able to do that.

In 2015, the Center for Disease Control estimated that limited mobility was the most common form of disability in the United States, impacting about 13% of adults. The National Health Interview Survey found similar results, stating that about 18.2 million adults in the US are unable to walk even 1/4 of a mile.

Mobility4

There were mile markers on the trail that I was walking along, placed every quarter of a mile. Each time I passed one I was reminded of these statistics. Besides feeling fortunate to have the ability to walk, I was also feeling excited to have picked such an intriguing area of research and clinical practice. Gait and balance impact so many aspects of a person’s life, these abilities can be threatened by myriad conditions and restored via many therapeutic interventions. This means job security and ample opportunity to make a positive difference. Tomorrow I will go back to preparing the PowerPoint. I will turn these rambling thoughts into tidy bullet points, and then I will deliver them to a hall full of sleepy students. Maybe I can change the way that some of them think about walking.

 

Walk well!

 

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