Treadmill walking yields lower self-selected speeds and altered spatiotemporal patterns compared to overground walking across inclined terrain: Implications for mobility assessment in older adults

Treadmills (TM) are widely used for gait assessment in older adults (OA), yet their ecological validity across inclined terrain remains underexplored. This study compared spatiotemporal, physiological, and kinetic gait outcomes between TM and overground (OG) walking across flat, uphill, and downhill terrain in OA and younger adults (YA), and examined sensorimotor predictors of speed discrepancies.

Continue reading at PubMed →

Treadmill-based mobility assessments may underestimate self-selected walking speed and distort gait metrics in older adults on inclined terrain; clinicians using treadmill protocols for balance or mobility screening should interpret results cautiously and consider overground alternatives.

If treadmill gait assessments systematically alter walking behavior in older adults, rehabilitation and fall-risk evaluations built on treadmill data may have reduced validity, affecting a large and clinically important population.

1. 01Older adults walk at lower self-selected speeds on treadmills than overground, even on inclined terrain.
2. 02Spatiotemporal gait patterns (e.g., step length, cadence) differ between treadmill and overground conditions.
3. 03Findings challenge the assumption that treadmill walking is a valid proxy for real-world mobility.
4. 04Implications extend to fall-risk screening and rehabilitation outcome measurement in older populations.
5. 05Mobility assessment environment should be considered when interpreting clinical gait data.

PMID

42906376

DOI

10.1016/j.gaitpost.2026.110669.

Journal

Gait & Posture

Publication type

research_article

Evidence level

2b

Population

Older adults assessed during walking on inclined terrain

Intervention

Treadmill walking across inclined terrain

Comparator

Overground walking across inclined terrain