Back to the Future - Cobblestones!

Summarized by Robert W. Griffith, MD
October 10, 2005

Introduction

As we get older most of us are a little frailer and more liable to experience falls. And, of course, we're more at risk of high blood pressure and becoming overweight. So exercise - especially walking - is advisable. Meanwhile, in recent years the benefits of acupressure have become more readily accepted by Western physicians. Acupoints on the soles of the feet are associated with healthy aging, according to Chinese traditional medicine, so the idea of stimulating such pressure points while walking seemed worth exploring.

In a pilot study, scientists in Oregon found there were benefits in physical and mental health in participants who walked on a cobblestone mat over an 8-week period. This provided the impetus for a controlled study, which has now been reported in the Journal of the American Geriatrics Society, and which we summarize here.

What was done

They were assigned at random to join a cobblestone mat-walking or a conventional- walking group. The cobblestone mats were 6 feet long and 1.5 feet wide, and contained hard plastic replicas of small to medium-sized river stones, randomly located; these mats were placed on padded underlays. Participants had to be taught how to walk on the stones. Initially they had to walk "in place" using one mat, stepping on and off it; later they walked along a path formed by mats placed end-to-end to make a rectangular track.

They were assigned at random to join a cobblestone mat-walking or a conventional- walking group. The cobblestone mats were 6 feet long and 1.5 feet wide, and contained hard plastic replicas of small to medium-sized river stones, randomly located; these mats were placed on padded underlays. Participants had to be taught how to walk on the stones. Initially they had to walk "in place" using one mat, stepping on and off it; later they walked along a path formed by mats placed end-to-end to make a rectangular track.

During the acclimatization phase mat-walking was increased from 6 minutes to12 minutes per session over a 2-week period, reaching a maximum of 30 minutes per session for the last 14 weeks of the study.

Conventional walking was arranged so that the program resembled that for mat walking, but was carried out in groups outdoors when possible, or indoors when the weather was bad. Walking intensity was monitored and controlled so that it was about the same for mat walkers and conventional walkers.

Effectiveness of the treatment was based on measures of balance, physical performance, and blood pressure. Additionally, safety was monitored carefully, by asking about any adverse effects at the end of each exercise session.

What was found

The participants averaged 72 years of age; about one third of them were women. Their average BMI was 27.6 (i.e. overweight but not obese), and two-thirds of them were taking regular medication.

At the end of 16 weeks, there were clear-cut differences between the two treatment groups:

• Balance - mat-walking participants' scores on the two tests of balance improved significantly more than those in the regular-walking group.
• Physical performance - the mat-walking group performed significantly better than the conventional walking group in chair-standing and speed walking tests.
• Blood pressure - there were significantly greater reductions in systolic and diastolic pressures in the mat walkers compared with the conventional walkers.

Quality-of-life scores were the same for both treatment groups. There were no adverse events or falls associated with either type of walking.

What these findings mean

The results of the study are surprising, but clear-cut. The benefits with regard to balance and physical performance, however, could readily be expected from the added use of muscles supporting standing and moving on an uneven surface.

The reductions in blood pressure were statistically significant, i.e. they could not have occurred by mere chance. One must therefore give more credence to the science behind acupressure and other interventions that involve massage or manipulation of the feet, such as reflexology.

This study represents a link between traditional approaches (walking as a health measure) and alternative medicine (acupressure, reflexology, etc). It will doubtless be followed by more studies investigating the mechanism of the effect on blood pressure in detail - for instance, measuring hormones and neurotransmitter substances in the blood in response to mat walking.

Meanwhile, older folk can be encouraged to take up cobblestone walking or mat walking (if they can find either), provided their feet and ankles are healthy. Maybe hiking over rough land would do as well. The risk of falls does not appear to be increased, and there are obvious benefits to be obtained.

Source

• Schweizerische Vereinigung für Ernährung / The Swiss Association for Nutrition (SAN). Merkblätter zur Ernährung, Vol. II. Main Editor: Herr Hansjörg Ryser, Bern. Website at : http://www.sve.org/english/index.html

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