Abstract:
Briefly, adjustably sloped simulated walking or exercise surfaces having multiple handles at multiple heights or positions are disclosed.

Description:
RELATED APPLICATION 
       [0001]    This patent application is related to provisional patent application Ser. No. 61/785,861, filed on Mar. 14, 2013, by Goldman, titled “ADJUSTABLY SLOPED SIMULATED WALKING OR EXERCISE SURFACE HAVING MULTIPLE HANDLES AT MULTIPLE HEIGHTS OR POSITIONS,” herein incorporated by reference in its entirety and assigned to the assignee of presently claimed subject matter. 
     
    
     BACKGROUND 
       [0002]    1. Field 
         [0003]    This disclosure relates to handles and/or handrails incorporated into exercise equipment, such as a treadmill. Specifically, it relates to the positions and height of the handles that is made available to provide support, at multiple heights and positions, to optimize support available for users of the treadmill, for whom specific individual spine or body position is helpful to allow successful use of the exercise equipment. This includes but is not limited to individuals with Spinal Stenosis, or Pseudostenosis, or related or unrelated orthopedic, arthritis, or medical conditions. 
         [0004]    2. Information 
         [0005]    A treadmill is an exercise machine for running or walking while staying in one place. The machine provides a moving platform with a wide conveyor belt and an electric motor or a flywheel. A manual treadmill allows motion without a motor. Conveyor belt moves to the rear, allowing a person to walk or run. The rate at which the user moves is the rate of walking or running. The speed of running and walking may be controlled, as may the angle of inclination of the supportive platform and belt of the treadmill. 
         [0006]    The treadmill is used for several purposes, including but not limited to exercise, rehabilitation, and diagnostic testing in patients with suspected cardiovascular problems, and other uses that may be determined by need or interest of individuals. 
     
    
     
       BRIEF DESCRIPTION OF DRAWINGS AND PICTURES 
         [0007]    Claimed subject matter is particularly pointed out and distinctly claimed in the concluding portion of the specification. However, both as to organization and/or method of operation, together with objects, features, and/or advantages thereof, claimed subject matter may best be understood by reference to the following detailed description if read with the accompanying drawings and explanations in which: 
           [0008]      FIG. 1  is a picture from 2013 article, of patient 4′10″, with pediatric folding walker set at 26 inches. 
           [0009]      FIG. 2  is a picture from attached 2013 article, of patient 5′11 inches and kyphosis needing a walker at 32 inches for functional improvement. 
           [0010]      FIG. 3  is a picture from attached 2013 article, of patient with walker handles too high for comfort, inducing shoulder and arm pain with use. 
           [0011]      FIG. 4  shows a Sammons Preston 562835 SportsArt T652M Treadmill, with handrail extension (Source: http://www.sportsartamerica.com/saf/commercial/treadmills/t611.asp) 
           [0012]      FIG. 5  shows an orbiter treadmill (Source: http://orbitertreadmill.com/pro-sports.html) 
           [0013]      FIG. 6  shows two views demonstrating mechanisms to maintain the spine in proper position by adjusting the arms in matters not conducive to long-term comfort or benefit. 
           [0014]      FIG. 7 : A side view of a “tread lower side handle” embodiment. 
           [0015]      FIG. 8 : Top views of a “tread lower side handle” embodiment. 
           [0016]      FIG. 9 : A view from the front of the “tread Lower side handle” embodiment. 
           [0017]      FIG. 10 : A side view of a “tread lower side handles” embodiment superimposed upon an image of a treadmill, that demonstrates the position and functional advantage of this embodiment. 
           [0018]      FIG. 11 : A frontal view of a framed embodiment of a “tread lower transverse front handle” 
           [0019]      FIG. 12 : A side view of a “tread lower transverse front handle” embodiment 
           [0020]      FIG. 13 : A side view of the Tread Lower transverse front handle” modification superimposed upon an image of a treadmill, that demonstrates the position and functional advantage of this embodiment. 
           [0021]      FIG. 14 : A side view of “tread lower transverse front handle” embodiment that has been rotated to a different position, 
           [0022]      FIG. 15 : A frontal view of “tread lower transverse front handle” superimposed upon an image of a treadmill, that demonstrates the position and functional advantage of this embodiment. 
       
    
    
     DETAILED DESCRIPTION 
       [0023]    Reference is made in the following detailed description to accompanying drawings, which formed a part hereof, wherein like numerals may designated like parts throughout to indicate corresponding and or analogous components. It will be appreciated that components illustrated in the figures have not necessarily been drawn to scale, such as poor simplicity and/or clarity of the illustration. For example, dimensions of some component may be exaggerated relative to other components. Further, it is to be understood that other embodiments may be utilized. Furthermore, structural and/or other changes may be made without departing from the claimed subject matter. It should also be noted that direction&#39;s and/or references, for example, up, down, top, bottom, and so on, may be used to facilitate discussion of drawings and/or are not intended to restrict application of cling and subject matter. Therefore, the following detailed description is not to be taken to limit claimed subjects matter and/or equivalent. 
         [0024]    References throughout this specification to “one example”, one feature,” “one embodiment,” “an example,” “a feature,” “an implementation,” or “an embodiment,” means that a particular feature, structure, or characteristic described in connection with the feature, example, or embodiment, is included in at least one feature, example, or embodiment of claims subject matter. Thus, appearances of the phrase “in one example,” “an example,” “in the one that implementation,” “an implementation,” “an embodiment,” or “in one embodiment” in various places throughout the specification are not necessarily all referring to the same feature, example, or embodiment. Particular features, structures, or characteristics may be combined in one or more examples, features, or embodiment. The term “user” and “individual” may be used interchangeably herein. The term “spinal stenosis” as used herein, may include any known and/or suspected condition involving the lumbosacral spine, or one or more adjacent structures, in which changing lumbosacral flexion and/or extension may affect spinal nerve compression and/or position of any spinal structure, potentially resulting in local, nerve induced, and/or other symptoms. The term “arthritis” as used herein and may include any known and/or suspected condition involving damage, pain, and/or inflammation of one or more joints of the body, such as shoulders, elbows, hips, knees, and so forth. Spinal Stenosis, or PseudoStenosis, as defined in the 2013 Journal of the American Podiatric Medical Association article attached, are often the cause of symptoms otherwise identified as poor circulation, arthritis, fibromyalgia, neuropathy, and others. For this reason, the benefit of the treadmill modification in providing clinical relief is not limited to patients diagnosed with Spinal Stenosis, and this application, though focused on benefit to individuals with spinal stenosis, is also meant to seek patent for these modification that can be helpful for any patient with related or possible related walking difficulty, with or without recognized overlap of symptoms with Spinal Stenosis. 
         [0025]    Individuals with Spinal Stenosis or Pseudostenosis (and other orthopedic, neurologic or other medical conditions) are often unable to use a treadmill because of symptoms similar to those experienced by these individuals during standard walking activities. Spinal Stenosis is defined as a condition in which narrowed structures in the lumbar spine cause clinical symptoms. These include localized back pain, neurogenic claudication symptoms in the legs, or neurogenic positional pedal neuritis symptoms in the feet, and other presentations of discomfort that may involve the back, hips, thighs, knees, legs, ankles, and/or feet, causing symptoms, including a limitation of ability to walk, or stand, or find a comfortable position, and may result in increased body strain affecting other organ systems. 
         [0026]    Pseudostenosis is defined as a condition in which dysfunction of the lower extremities affects the function of the spine, producing either spine or lower extremity symptoms similar to Spinal Stenosis, which may be in the presence or absence of structural Spinal Stenosis. Lower extremity pathology that may cause pseudostenosis includes, but is not limited to, uneven limb length, flat feet, arthritis, and others. Pseudostenosis, as is defined in this application, was first published in an article in the March 2013 issue of the Journal of the American Podiatric Medical Association. That article is included with the application. 
         [0027]    Both Spinal Stenosis and Pseudostenosis induced symptoms may be reduced or eliminated by optimizing spine position. Specifically, flexion may open up both the central canal and/or lateral foramen of the spine, reduce both local arthritic symptoms, and those symptoms caused by nerve compression or irritation. 
         [0028]    Other orthopedic, neurologic or medical conditions can also cause symptoms affected by standing and walking. They may be present in the presence or absence of Lumbar Spinal Stenosis or Pseudostenosis. For the purpose of identification of people that may be helped by having the structural support of this application, the term “Spinal Stenosis” as used in this application should be understood to include individuals with either Lumbar Spinal Stenosis, and/or Pseudostenosis, and the term “other conditions” should be understood to include other orthopedic, neurologic, or medical conditions with symptoms that may be exacerbated by walking, standing, or using exercise equipment such as a treadmill. 
         [0029]    Individuals with Spinal Stenosis have been reported to have dramatically increased walking capability by using a walker whose handles had been set at a level which induces lumbo-sacral flexion in that individual. Literature (published in medical, diabetes, and podiatry journals by the applicant of this application) has reported that an exact or near exact handle height is often necessary for optimal improvement to occur, and that handle height must be measured or set for the individual, and cannot be accurately extrapolated from the individual&#39;s height. The reason for clinical improvement is the recognized anatomic phenomena that flexion of the spine increases the diameter of the spine and its lateral components, and that extension narrows these structures. In that Spinal Stenosis by definition involves narrowing of these structures, flexion induced opening may alter the symptoms caused by this condition. The need for specific handle height is based upon many factors including the height of the individual, but also affected by the relative proportion of the height of the legs to the overall height of the individual, length of the arms, the changes in proportion that may have occurred with diminished height seen frequently with age, the amount of lumbo-sacral flexion needed to induce adequate opening of the central canal and lateral foramen whose compression can induce symptoms, and other factors. The multiple factors that may affect the individual&#39;s need for specific handle height prevent the ability to predict height of handle needed for an individual based solely upon the individual&#39;s height. It is essential for positional management that the position of the handle induces the needed lumbar position while the arms are held extended, and with the person in a comfortable position, not leaning too far forward. Leaning too far forward is often not comfortable for individuals. Leaning forward but with the arms flexed often causes an uncomfortable or tired feeling of the arms and shoulder. Discomfort may be enough to induce the person to stand straighter, eliminating benefit of the positional management. This explanation of why appropriate handle height is essential for success with presents why exact or near exact handle height is needed for optimal improvement with a walker. 
         [0030]    Concept of need for specific walker handle height to induce lumbosacral flexion has been termed “positional management”, and was reported initially in medical, diabetes, and podiatry literature solely by the application of this patent application. This was first published in May of 2003 in an article of the Journal of the American Podiatric Medical Association, which is included with this application. The specific terms of the current protocol components of positional management, including Positional History, Positional Testing, and Positional Therapy, were first published in Diabetes, in an abstract in 2005, solely by the applicant of this patent application, and then further disseminated in a full journal article in the Journal of Family Practice in 2008, which is included with this application. Greater clarity of the details is presented in a full journal article in the Journal of the American Podiatry Association, March 2013, which is included with this application. 
         [0031]    Walkers currently commercially generally have mechanisms available to be adjustable to the multiple heights. This may allow adjustment to provide optimal positioning for patients with spinal stenosis or other related or unrelated conditions Retrospective review of 250 patients of the author of this application of successfully treated with positional management for spinal stenosis with use of a walker identified that each had been fitted with walker handle height that was between 35 and 26 inches off the ground (unpublished data). Different brands or models of walkers have different handle height range. Different types have different height range, such as a “pediatric” or “junior” walker having lower handle height ranges than standard models. Pictures demonstrating different walker models, and set at different heights as required by the individuals using them, follow, with descriptions attached. 
         [0032]    Currently art, including commercially available treadmills, does not include apparatus needed to easily or optimally address the need for varied or multiple handle positions of different heights, to satisfy the needs of individuals, such as those with spinal stenosis or other conditions, who require specific body or spine position for optimal comfort during exercise. Some variations of available treadmills include a slanted front handle, slanted side handle, or extended handle/handrail. Pictures demonstrating different treadmills with handrail variations follow. 
         [0033]    The treadmills of  FIGS. 4 and 5  and similar existing treadmills have a sloped handle that presents a lower position for handle placement than standard treadmills. This does not interfere with this set of claims as the sloped handles on these models and other similar treadmills with sloped handles do not provide all the benefits of the apparatus presented in this claim. It may also be noted that the handles being available for people with spinal stenosis or other conditions does not appear to be of concern in the presented art, as this potential benefit and the height variation of the handrail sections is not mentioned in on line advertisements of the two companies who produce these treadmills. 
         [0034]    Regarding the SportsArt treadmill of  FIG. 4 , though the long handrail extension has lower handle height, there are several factors that interfere with optimal function for many people with spinal stenosis and other conditions. They include the following: 
         [0035]    a. For shorter people or some who need to flex aggressively to use this handle, which extends to the back portion of the treadmill, the user must be in the back portion of the treadmill, and away from the treadmill controls. 
         [0036]    b. For shorter people or some who need to flex aggressively to use this handle, depending on the handle height required, the position chosen can put the user close to the back of the treadmill which may restrict the space available for normal stride length, for walking or running. 
         [0037]    c. For shorter people or some who need to flex aggressively to use this handle, depending on the handle height required, and the amount of flexion needed, the feet may be too far back on the treadmill for them to be able to stay on the treadmill and use the positional management position of having arms extended straight, with the spine adequately flexed, and the arm position being extended comfortably close to the body. This will result in two potential changes in position, each of which can eliminate the benefit of positional management. 
         [0038]    a. The individual could either keep their elbows bent and walk further forward on the treadmill, and lose the benefit of optimal positioning for spinal stenosis. 
         [0039]    b. They could also extend the elbows straight, but keep the hands so far forward that it is a more strained and problematic position, putting extra mechanical stress on their upper arms and shoulders. 
         [0040]    d. The handle extension descends and is no longer coplanar with the supporting surface of the treadmill. In that many people with this condition already use a walker that has handles parallel to the supporting surface of the ground, handles parallel to the supporting surface of the treadmill is a more familiar position that they have experience and confidence with, an important consideration for people with limitation associated with Spinal Stenosis or other conditions. This downward angle of the handle induces a different leaning position, and may require the arms to be further forward, so that the user is not leaning primarily down but leaning significantly forward (into) on the handles. A similar angulation can be induced in a standard folding walker by setting the back legs at a lower level. Many people find the position of leaning forward (into) on the handles uncomfortable and refuse this handle position. Extrapolation suggests that this position may also be less comfortable for many people using the treadmill. In that for some people the angle of 90 degrees from the arm and hand to the handle is comfortable, use of the handle in a downward slope requires either leaning in to it, which may be uncomfortable, or to have the elbows bent in a manner which allows the arms to angle forward. This second position may cause arm and shoulder discomfort and expends energy. It eliminates the value of having arms straight, elbows locked, and leaning down, for spinal stenosis patients, as has been described in greatest detail in the March 2013 JAPMA article attached. 
         [0041]    e. These problems are all resolved with use of the apparatus claimed, as is described below. 
         [0042]    Regarding the Orbiter treadmill of  FIG. 5 , there are factors that interfere with optimal function for many people with spinal stenosis and other conditions. This has an oblique downward directed handle. This would strongly force a leaning forward position for anyone needing to keep arms straight as is recommended using the positional approach for spinal stenosis and related conditions. This is often an uncomfortable position for people, especially those who medical or arthritic pathology such as Spinal Stenosis and other conditions. In addition, those who lean into the supporting handle, would be close to the back (or off) the supportive surface. In addition, those who bend the elbows, lose benefit of positional management. These problems are resolved with use of the apparatus claimed, as is described below. 
         [0043]    Regarding the oblique front handle available on some treadmill models, this provides a variation of heights, but is limited to a small range of available heights. 
         [0044]    A treadmill is an exercise machine for running or walking while staying in one place, that may be used for several purposes. The supporting handle of the treadmill may be on the side, or in the front, and may be used by some individuals to maintain body position while walking or running. The term handle refers to a grip or the like specifically design for holding and/or clasping by one or more hands during use of the treadmill. Uses of the treadmill include but are not limited to: 
         [0045]    a. Exercise for individuals without related medical conditions, such as for conditioning or weight loss. 
         [0046]    b. Rehabilitation for individuals with a wide variety of medical problems who attempt to overcome problems with deconditioning caused by the medical problems. 
         [0047]    c. Diagnostic testing in patients with suspected cardiovascular problems, via the treadmill stress test. 
         [0048]    d. Others as determined by need or interest of individuals. 
         [0049]    Individuals with symptomatic spinal stenosis have been reported for many years in literature written by the applicant, to improve walking and reduce symptoms by using external support such as a walker, that facilitates attaining and maintaining a position of comfortable lumbosacral flexion to reduce or eliminate the pain and walking limitation that frequently is seen in patients with spinal stenosis. See the accompanying articles, published between 2003 and 2013, that describe this benefit in walking capability as well as overall symptoms. It is stressed in each article that specific walker height is essential to obtain optimal improvement for many patients. As reported with greatest detail in the 2013 article, individuals with Spinal Stenosis can respond to imperfect lumbosacral support in different manners. If the support induces the optimal spine position, there is usually an increase in comfortable walking, and reduction or elimination of either symptoms or exacerbation of other symptoms associated with spinal stenosis. 
         [0050]    An explanation of the possible responses to non optimal handle height is provided to support the value of having optimal handle height. This set of observations is extrapolated from successful management of individuals, with walker use. If handle support height is too high, it is common that individuals do not obtain the optimal flexion position to reduce symptoms emanating from or through the spine with Spinal Stenosis. This pattern is commonly seen in individuals who do not walk better with a walker in which the handles are too high, just as many individuals do not walk better with a treadmill as the handle height is too high to induce or facilitate comfortable lumbar flexion. As reported in the accompanying articles, this applicant has seen dramatic improvement in walking capability and pain level of patients following adjustment of a walker to an optimal height, usually one in which slight lumbosacral flexion was induced. Nevertheless, individuals can still obtain the benefit of appropriately flexed lumbo-sacral position by two compensatory behaviors, which are labeled as sub optimal. An individual may flex the arms while leaning forward, in a way that induces flexion, but often causes shoulder and arm strain and/or tiredness or pain in individuals, and may induce shortness of breath in individuals with a reduced functional capacity. This can be counterproductive to individuals using a treadmill to improve their cardiovascular status. Another way to compensate for handle height that is too high is to flex at the spine, keep the arms straight as is optimal, but hold the walker or other support very far forward in front of the individual. This can also cause arm, shoulder or torso discomfort, and often induces a feeling of chasing the support device, as it is too far in front. Many people report this is uncomfortable, and note immediate improvement when the handle support is placed at a more appropriate height. The lack of optimal improvement in so many patients with a too high walker handle height supports the observation that these two compensation maneuvers are intrinsically less comfortable. These two compensation behaviors are shown above in  FIG. 4 . If the handle height is too low, the individual may either hold the handle lightly with the tips of the fingers to reduce flexion but in a way that does not provide stable support, or hold the handles and thus cause excess flexion, which may result painful symptoms. 
         [0051]    This application embodies apparatus built in to a treadmill, with variations of handle position and height that may be used in treadmills or other exercise equipment, that are unique in that by design they allow multiple concurrent handle positions at different heights, that provide multiple heights for both side handles and front transverse handles, to provide support for body positioning to accommodate the needs of individuals with spinal stenosis or other medical conditions. This apparatus and variations claimed do so by having multiple handle heights, all in the front section of the treadmill where handles traditionally are and whereby use allows the user easy access to controls. With the many handle heights available, the user may choose the handle height that is most comfortable for their physical needs, leaning with the arms straight, and allow the ability to change height easily, and thus self adjust when desired, with having no need to modify the treadmill device in any way. 
         [0052]    This application also embodies apparatus that serves as a treadmill handle modification that can be retrofit to existing treadmills, to be attached temporarily or permanently, to supplement or replace functional use of either side handles and/or front transverse handles, to allow multiple handle heights, so as to provide optimal handle heights to accommodate individuals with spinal stenosis or other medical conditions. It does so by having multiple handle heights, all in the front section of the treadmill where handles traditionally are, so that an individual may choose the handle height that is instinctively most comfortable, and self adjust when desired, with having no need to modify the treadmill device in any way. Good support height is always made available. 
         [0053]    The number of handle heights available is enhanced by including not only bends in the handle, as is demonstrated, but also by having 2 or more handles, which are accessible to the user because they are staggered in a manner that allows access to the lower handles without being blocked by the higher handles. The higher handles on both side and front apparatus are further away from the center of the body of the user, allowing access to lower handles without interference from higher handles. In that the term handle may refer to a specific section of a handle bar, throughout this application the term “bar” shall refer to the structure within any manifestation or embodiment of this apparatus that may comprise the physical structure that serves as a handle. 
         [0054]    The design of the front handles (referred to as “Tread Lower Transverse Front Handle” demonstrated by art submitted includes a 40 degree downward slant from the middle section, to both allow comfort of the hand on the handle, but which also allows greater variability in hand height on each handle. This positioning may or may not be optimal, but will be functional. The selection of this position does not exclude from this application any other shape or bend or angle of the multiple bars. In addition, the center portion of the bar may be small, for example 2 inches, to allow greater room on each side bar, or could be wider, for example, 10 inches wide to give users the option of using the totally transverse section for support. The representative embodiment is not meant to limit the claim of this application, which should include all variations of shape and apportionment of size of sections. 
         [0055]    The design of the side handles (referred to as Tread Lower Side Handle” as shown allows three different handle heights per bar, which may be a single bar bent, or 3 handle sections attached, with each handle being parallel to the supporting surface of the treadmill. This positioning is felt to be optimal, but the selection of this position does not exclude from this application any other shape, or bend within a single bar, or angle of the multiple or individual handle sections to the supporting surface. The design of the “Tread Lower Side Handle” shows two staggered bars, with handle heights at 2 inches apart. Alternative embodiment, not shown, could be having three staggered handles, with height differential at 1.5 inches apart. Alternative embodiment, not shown, could have two or three or more straight handles at different heights, angled downwards and backwards at a specific angle such as but not necessarily 25 degrees, that would be staggered to allow concomitant access. Demonstrated art does not in any way exclude from this application any variation in the shape, or specific number of handles, or height differential between handles. 
         [0056]    A primary advantage of these modifications is to allow individuals to walk with the hands holding the handles, and the arms straight, inducing and maintain the spine or other body part in an optimal sagittal plane position. A secondary advantage is a solution to a separate but related problem. Individuals with stenosis often report an increase in symptoms and difficulty walking and they find that symptoms return when they walk up hill with a walker, even if the walker has been set at the optimal handle height for that person. They walker handles are then positioned higher relative to the person, as the walker is higher on an incline. Depending on how sensitive the individual is to spine induced symptoms, they may experience such symptoms quickly when the spine position induced by the walker is altered to a more extended position. In order to maintain optimal spine position, the individual may flex their elbows and or shoulders. This maneuver may be taxing physically, because of increase demands on arm and shoulder muscle function, and may also cause shortness of breath in individuals with a diminished cardiovascular capacity, as is reported in the 2013 article attached. This problem is relieved by the presence of multiple handle heights, so that when walking on the treadmill in an incline manner, as is used for exercise, the person can choose a lower handle height to improve spine position, with no adjustment needed for treadmill device in any way. 
         [0057]    It is observed that individuals with symptomatic spinal stenosis often intrinsically sense the proper height of handle, and will gravitate to that height if there are no factors inducing them to reject this handle height. For this reason, having all handle heights available at all times allows the individual to select handle height based upon physical comfort, without assistance of medical professional, exercise assistant, or caregiver. It is not possible to predict the optimal height for an individual person, as many factors that influence optimal height, including but not limited to, the height of the individual, the length of the arms, the proportion of height of the legs to the overall height of the individual, the amount of kyphosis present, arthritis with limitation of motion of the elbows or shoulder, and the amount of lumbosacral flexion necessary to induce adequate opening of the central spinal canal or lateral foramen, and other factors. In other instances, appropriate height of the handles may be influenced by symptoms and positioning limitation of the elbows, hips, knees, shoulders, and/or neck, for example. There may even be different optimal handle heights for the two arms. Having the many different handle heights available allows the patient to select that which is most comfortable, to change if desired, and to experiment, without need to adjust the treadmill. It is also known that spinal stenosis symptoms are often inconsistent, so that symptoms may be present and require a certain spine position on one day, but not be present requiring that spine position on another day. Finally, in that the treadmill may be used by more than one individual that have different optimal handle heights required, even if in a private domicile, having the multiple handle heights all available without needed adjustment, is advantageous. For these and other reasons, having multiple handles available concurrently facilitates compliance with use of the optimal handle height. 
         [0058]    Claimed matter is not limited in scope to the illustrated embodiments or implementations. That shown and described are individual representations, but all variants of the handles that include the advantages of the presented scenarios are claimed. For example, the angle of the bend, the size or shape of the bar, the covering or lack of covering on the support bar, the length of the individual handle sections of the bar, the number of offset bars in the embodiment, the distance between the offset bars, the distance between each height of each handle section, and all other variations of this structure are included in this claim. 
         [0059]    The illustrated embodiment shown in  FIGS. 7 ,  8 ,  9 , and  10  is a labeled as “tread lower side handle” and is a replacement for the single height side bar standard on most treadmills, whether that bar is extended, or slanted. In this embodiment, there are six handle heights concurrently available. Each handle is 5 inches long, and 1.5 inches in diameter. There is a two inch difference between height of each handle, measured from the center of the handle, so that, for example, the handles may be set at 36, 34, 32, 30, 28, and 26 inches above the supporting surface of the treadmill. In this embodiment there is a six inch space between the higher and lower adjacent handles. The higher handle is offset three inches, outside the bottom handle, to allow easy access to the lower handle. Poles or other supporting apparatus secure the top handle section of “tread lower side handle” to the lower handle section, and secure it to some stable part of the frame or other section of the treadmill. In this embodiment, the handle sections are all coplanar to the walking surface, so that the handles are in position similar to the rollator or folding walker the individual may be familiar with and use. 
         [0060]    A variation of this or other embodiments would be to add mechanization that would automatically adjust the handle position when the angle of inclination of the treadmill walking surface is altered. Another variation to this or other embodiments would be to connect the bars supporting the handle sections to the base, so that maintaining a parallel position to the supporting surface would occur as altering the walking surface and it&#39;s supporting structure could also alter the handle section. 
         [0061]    The illustrated embodiment shown in  FIGS. 11 ,  12 ,  13 ,  14  and  15  are labeled as “Tread Lower Transverse Front Handle” and is a replacement for the single front bar standard on many treadmills. This is accurately described as a single bar even though the oblique angle present in some bars allow some variation in hand height position supported. However, this variation in hand position is limited to a few inches, and does not support the great variation in handle height needed to provide optimal position support for the wide range of spinal stenosis patients. 
         [0062]    In the illustrated embodiment, shown in  FIGS. 11 ,  12 ,  13 ,  14 , and  15 , there are 5 handles concurrently available. In a single embodiment, the highest position may be 42 inches in height, which is the height of the handle of many grocery carts. The demonstrated embodiment has bars have a transverse section to separate right and left, and then the bars extend outward and downward by 40 degrees, giving multiple handle height positions for each bar. Each bar is 1.5 inches in diameter, and there are 4 inches of space in height between the center of each bar. Each bar is offset, backwards being towards the back of the treadmill, with 3 inch difference between the center of the two adjacent bars, resulting in 1.5 inch posterior offset, and 2.5 inch difference vertical offset. Poles or other apparatus secures the top handles to the lower handles, and secures it to some part of the frame of the treadmill. It may be understood that the oblique section of this bar may allow handle positioning of approximately but not exactly 2 inches below the transverse section. This allows this embodiment to have a range of 18 inches of different height of hand positions. The 18 inch total variation in handle height allows a wide range of handle people of different heights and spine position needs to have support without excessively leaning forward. The handles are in the front half of the treadmill, so there is not shifting of shorter users backwards toward the back of the treadmill. Depending on the amount of separation between heights of the bars in other embodiments, there may be more or less staggering of the bars necessary for comfort. 
         [0063]    Either “Tread Lower Side Handle” or “Tread Lower Front Transverse Handle” may be designed as units that can “retro fit” to existing treadmill using standard mechanisms including clamps, and thus provide the advantage of optimizing body position and facilitating exercise, without need for new capital purchase. Attachment could be either permanent attachment, or temporary and removable attachment, using commonly available art. 
         [0064]    Both “Tread Lower Side Handle” and Tread Lower Front Transverse Handle embodiments may be place on a single treadmill unit or style, either built in, or available for “retro fit”. This would maximize the options of hand placement for any user. 
       Detailed Explanation of Figures 
       [0065]      FIG. 6  shows two views demonstrating the mechanisms to maintain the spine in proper position, by adjusting the arms in manners not conducive to long term comfort or benefit for individuals who would benefit from specific positions, are demonstrated on a standard treadmill by an individual who is 5′3″. 
         [0066]      FIG. 7  is a side views of a “tread lower side handle” modification. In this embodiment, there are six handle heights concurrently available for users of a treadmill. Each handle is 5 inches long, and 1.5 inches in diameter. There is a 2 inch height position difference for each handle so that handles may be set, for example, at 36, 34, 32, 30, 38, and 26 inches above the treadmill walking surface. The top handle section, with three handles, is offset 3 inches outside the bottom handle to allow easy access to lower handle. This is not seen from this angle, but is seen in following figures. Poles or other apparatuses secures the top handle section, which is offset, to the bottom section, in both the front (square dots) and in the back (round dots). This embodiment demonstrates by the dotted line potential attachment to forward structures in the frame of body of the treadmill. 
         [0067]      FIG. 8  is a Top view of the “tread lower side handle” modification that includes 6 handles with 6 heights, and is meant to be viewed and understood with  FIG. 7 . As in  FIG. 7  a above with multi colored handles, the front handle is the top one, black, 2 inches lower is striped, and two inches lower is oblique pattern. For this embodiment, the outside black Is meant to be set at 36 inches, outside striped is 34, outside oblique is 32, inside black is 30, inside striped is 28, inside oblique is 26 The outside upper handle is offset 3 inches on the outside, away from the center of the treadmill. In this embodiment representation, attachments of outside handle to inside handle are demonstrate by square dots in front and by round dots in back. 
         [0068]      FIG. 9  is a view from position of the front of the treadmill demonstrating position of the “tread lower side handle” modification that includes 6 handles at 6 heights. Each circle represents a different handle height with three on outside top handle section, and three on Inside bottom handle section. This version shows oblique bar securing two handle sections, with dotted bar in front attaching height 36 to 30, and dashed line in back Attaching handle height 32 to 26. Poles then secure bottom handle section to the base of the treadmill. Looking from a position from the front of the treadmill, this section is on the right, with the top handle being on the outside, and farther to the right. 
         [0069]      FIG. 10  is a side view of commercially available treadmill that has an embodiment of “tread lower side handle” modification shown in a way that demonstrates its position and purpose. Shown is this handle on the left side only of the treadmill, while function would have the modifications on both sides of treadmill. The top three handles are on the outside bar, and the lower three handles are on the inside bar. The photograph showing a treadmill exercise machine illustrates environmental structure and forms no part of the claimed design. 
         [0070]      FIG. 11  is a view of an embodiment of the frame of “tread lower transverse front handle”. This shows the establishment of multiple heights with this device. Shown is the frame of the apparatus and the 5 bars that provide the handles. Each bar is 1.5 inches diameter. There are 4 inches of space between tops of adjacent bars. Center section provides 10 inches of bar that may be used as a handle. The oblique section of each bar allows additional height selection positions for each bar that is approximately 2 inches below the transverse bar. The bars are offset three inches, from the center of the bars, to allow access to lower bars without interference from higher bars, though this cannot be seen from this perspective. Structure to attach this frame to the body of the treadmill is not shown, as this is not unique to this apparatus, and may be built in or retrospectively attached in many ways. There are five handles. Due to the availability of use of the oblique portion of the bar as a handle position, the lower hand position is 18 inches below the top handle position. 
         [0071]      FIG. 12  is a side view of “tread lower transverse front handle” modification. This shows the height variations of the center bars, being 4 inches from top to top of bar, and the offset positioning of the bars, being 3 inches offset or staggered, from front to front of bar. Each bar is 1.5 inches in diameter. There are 5 handles, and the offset positioning places the farthest posterior handle 12 inches behind the hightest. Due to the availability of use of the oblique portion of the bar as a handle position, the lower hand position is 18 iches below to top handle position. 
         [0072]      FIG. 13  a is a view from the side of a treadmill that has the “Tread Lower Transverse Front Handle” modification in place in a way that demonstrates its position and purpose. The photograph showing a treadmill exercise machine illustrates environmental structure and forms no part of the claimed design. 
         [0073]      FIG. 14  shows an embodiment in which “tread lower transverse front handle” is not in a fixed position, but rather has been rotated into a different position. In this position, only the central bars would be available for use, while the apparatus is in this position. The photograph showing a treadmill exercise machine illustrates environmental structure and forms no part of the claimed design. 
         [0074]      FIG. 15  shows the tread lower transverse front handle modification that is attached to treadmill and shows position of use. The photograph showing a treadmill exercise machine illustrates environmental structure and forms no part of the claimed design. 
         [0075]    4. Advantages 
         [0076]    The apparatus claimed, which includes multiple handle heights concurrently available, which in an advantageous embodiment would include all handles being coplanar to the supportive surface of the treadmill, overcomes the problems presented in the following manners. 
         [0077]    a. The user, even if short or requiring extensive flexion, is further forward and thus not far from treadmill controls. 
         [0078]    b. The user, even if short or requiring extensive flexion, is farther forward, and thus not in a position of being close to the back of the treadmill that might cause change in stride. 
         [0079]    c. The user, even if short or requiring extensive flexion, is farther forward, and thus not in a position of being close to the back of the treadmill that might induce not using the positional protocol of arms being straight and close to the body, that provides the clinical benefit of positional management. 
         [0080]    d. The user, even if short or requiring extensive flexion, is able to use the positional protocol of having arms straight and leaning either forward or downward on to the handles, based upon choice. 
         [0081]    e. The user is able to have the coplanar handle (on the Tread Lower Side Handle version) be parallel to the supporting surface, which is a known and comfortable position for many people, as compared to being forced to use an unfamiliar angulated handle position that may not be comfortable for some people. 
         [0082]    f. Those using the “tread lower transverse front handle” have the hands in front of them in a manner similar to the handle of a grocery cart, but many handle heights to choose from. 
         [0083]    g. In contrast to having handles available which are adjustable, as the handles of a walker, having multiple handles available concurrently facilitates ease of use when more than one person may use the equipment, as there is no need to adjust. Seeking the proper height on a walker often requires time consuming adjustment. The benefits of positional management are not readily known, but often self evident to patients when they have the choice of handle selection. Having the walker handles available for a user to self select is easiest, and may facilitate proper use. By facilitating proper use, it may also facilitate greater use. In that many treadmills, used either at private homes, or exercise areas such as gyms, or medical facilities that do stress tests, have multiple users, need for adjustment between users would potentially be an impediment. Therefore, concurrent availability of the many handle positions is an advantage.