How to Positively Affect Gait and Cognitive Function

By Beau Onouye

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Fear of falling is one of the main causes for older adults to alter posture and gait function. Compensations such as choppy steps, a shifted center of gravity towards the heels, and limited weight distribution (through the single leg phase of gait function) are all subconscious alterations to movement patterns. Although this improves relative stability, a rigid posture limits the range in which a person's center of gravity is able to deviate without losing balance. Therefore, stiff posture is a known indication for an elevated risk of falling. In order to combat these risk factors, skills such as picking up the feet to avoid dragging, distributing weight to lengthen each stride, and controlling center of gravity through an active range of motion must be stimulated to defend against unwanted outcomes. 

This is where the Fumanet comes in. Fumanet is a Japanese exercise program discovered in 2005 by Dr. Kazutoshi Kitazawa. Derived from the term ‘don’t step on’ the net, this program is proven to decrease risk factors associated with fall related injuries and dementia. The multitasking exercise is based on a 3x8 grid of squares where the main objective is to walk from one side to the other without stepping on the net. The Fumanet provides external feedback which requires the individual to consciously focus on proprioceptive functions (knowledge of where each limb is located in relative space) to stimulate efficient walking patterns. Parameters of the step net increase neural output of the individual to not only force an improvement in stride length between each heel strike, but also requires the participant to avoid dragging their feet. Consequently, weight distribution throughout the foot is required to complete the exercise which combats a flat footed walking pattern. Coupled with a very slow pace and multidirectional movements, the Fumanet exercise encourages participants to challenge their stability by limiting momentum through gait to target joint stability of the lower limbs. 

Cognitive improvements are facilitated through the incorporation of multitasking interventions. Not only do individuals need to focus on each stepping pattern but must also focus on rhythm, stability, pace, sequence, music, and simultaneous movements such as clapping each time the left foot strikes the ground. As a result, cognition must constantly be engaged to successfully complete each exercise. In Addition, the stepping patterns are always changing to which short term memory and executive functions facilitate full engagement from the brain. 

This low impact exercise is applicable to a variety of populations including individuals with physical and cognitive disabilities. People who use a walking cane, walker, or wheelchair have all participated in this program with the assistance of their supporters. Although the Fumanet exercise seems very easy when described, it is very challenging for all levels of fitness once it is done kinesthetically.

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