I have a number of cases which involve treadmill results. Tribunals seen to set great score by these but my view is that they are artificial measurements in clinically controlled environments and do not mirror a persons ability to walk out of doors over familiar routes. Does anyone know of any research about the use of such tests in relationship to DLA Mobility claims.

Thanks for any advice on this matter.

I have no medical expertise but I did have a heart attack nearly 6 years ago, so I know a bit from the patient's perspective. So please bear that in mind when reading my comments.
The treadmill test, also known as the Bruce Protocol, is a diagnostic tool to find out how the heart performs and the kind of damage it has sustained due to disease or MI. It is not testing mobility. It is less invasive than carrying out an angiogram - the angiogram carries a number of risks. it's not intended that you would repeatedly, or frequently, do a treadmill test. At the time of my heart attack, treadmill tests were only carried out in hospital with convenient access to the crash team! I had an angio early on, so have no first hand knowledge of the tradmill test.
If you google (other search engines are available!)"Bruce protocol" you will find all manner of info.
After I was ill, I was helped by the cardiac rehabilitation team at the local hospital - has your client been in cared for by them? The british heart foundation are also an invaluable source of help in this subject area.
Hope this helps,
Carol

Carol,

Sory for not replying earlier. I had just about given up hope of getting any answers or suggestions. Thanks for your personal experience of treadmill testing. Appeal tribunals in Scotland seem to treat this testing as the Holy Grail to refuse mobility allowance and now even the Commissioners are getting in on the same act.

Since I posted my query in Jnauary 06 I have learnt from specialists in heart treatment that the test is not conclusive in terms of Mobility ability and should not be treated as 'gold'evidence. However this information came too late for the appeal and could therefore not be used at the Commissioner. We are considering a Judicial Review on the grounds that the reasoning by both the appeal tribunal and Commissioner is unreasonable and would not be accepted by normal thinking. However, we are not too hopeful of getting the legal input which will be required on a pro bono basis. Anyway no matter what the result I will post it for future reference.

I have had several "treadmill tests" so I suppose I've picked up some knowledge.

I can see where a Doctor (probably the medical member of a tribunal) is coming from - but it's very sloppy thinking!. The purpose of a treadmill is to put a "load" on the heart and get the heart rate up to 120+ - and then to take measurements of the particular part of the cardio thorasic system being studied.

Cannot see how you can get up to a heart rate of 120+ without walkig far more than 50 metres, and walking quite briskly at that.The medical member probably has in mind that there is an alternative - high heartrate can be induced by drugs (this us used for patients where the exercise could be dangerous). It looks to me as if the tribunals are assuming that if you can do the treadmill test at all then this is incompatible with being virtually unable to walk.

But this is nothing to do with the correct test for Mobility and any tribunal citing this as a reason wants challenging on a point of law. On every test I have done I have gone through the "severe discomfort" barrier quite early in the test (in any other circumstances I would have stopped) so I consider any implications for mobility to be totally out of order.

the only observation I have is that a powered treadmill requires less muscular effort than real walking because on a treadmill no effort in forward momentum is required, only the swinging movement of the legs.

I don't this for a fact but it seems common sense to me. After all, I cannot run on the road further than the end of my street without severe discomfort (lol), but I can happily run on a treadmill for miles!

Clearly, as the previous poster points out, it would be useful evidence for a DM, but it should not necessarily be an overwhelmingly determinative factor.

It may depend what the test was used for. They are most usually done as a measure of cardiac function, but I have seen (just one) example in which the test was actually being done as a measure of mobility - I can't remmeber why, it may have been in connection with a compensation claim.
I often find (found - I hate running) that using a treadmill can be harder than walking or running on the ground, because you have no control over the speed and are forced to keep going (or you fall off, and end up with a huge and painful bruise on your coccyx the day before you are going on holiday...)

you need a more expensive model ariadne - one with in-easy-reach adjustable speed controls, a safety cut out switch and rear-mounted air bag...

It's not just that a treadmill may be more or less energetic than walking on level ground but the circumstances of a treadmill test completely undermines the correct test for mobility. It is carried out in a hospital with a Doctor and several nurses and technicians in attendance. The "victim" is plugged into several pieces of moinoring equipment and is repeatedly urged to go on a bit further or a bit longer - with the clear implication that this will improve the quality of the test results.

These circumstances almost guarantee that the "victim" will not only go beyond the threahold of "severe discomfort", but will go well beyond it - trusting that the medical personel can handle any serious problem.