Body-Weight Supported Treadmill Training with Neurological Populations
What is Body-Weight Supported Treadmill Training?
It’s a lot like how it sounds! This is a treatment which involves the client being supported in a suspension system, over top of a treadmill. This suspension system helps to support some of your body weight, while also creating a safe environment for you to practice walking (as it will help to catch you to prevent a fall!). While you are suspended and on the treadmill, your therapists can help you with leg movement to create a walking motion. Their assistance will not only help you with lifting your leg, they will also help you to maintain proper alignment, will facilitate muscles for improved activation, and will help with foot placement to mimic a more natural gait pattern for you.
What is the Evidence?
Body-weight supported treadmill training (BWSTT) is considered a non-invasive clinical approach to ambulation training. Evidence has supports its use as a task-based method of training, which has been shown to enhance neuroplasticity. A Cochrane review from 2014 also concluded that BWSTT improved walking speed and endurance in independent ambulation post-stroke. Other studies have found that BWSTT significantly influences use of gluteus maximus, lateral hamstrings, and gastrocnemius muscles during gait. These are muscles which are important for both stability and mobility with walking.
In looking at this form of training from a neurophysiological perspective, we can also see the potential benefit that this form of training can provide. Evidence shows that the variables that we use in BWSTT, such as alignment, speed, range, and cutaneous input contribute to the activation of Anticipatory Postural Adjustments (APAs) and Central Pattern Generators (CPGs). Essentially, this means that BWSTT can have a direct effect on postural control, balance, and rhythmical movement, which are all needing for independence with walking! BWSTT has the potential to improve your safety with walking, quality of walking, and overall standing and walking tolerance.
Patients have also reported that the assistance provided by the support system gives them more confidence to try treadmill training, to try walking at quicker speeds, and walk for longer periods of time. Knowing that your therapist and the harness system are there to support you and ensure your safety can be a great confidence boost, and give you peace of mind to try more challenging tasks, in a safe way!
Does It Only Work on Walking?
BWSTT is also not just for walking! It can also contribute to many patient specific goals including:
- Improving postural control
- Strengthening lower extremities
- Improving Endurance
- Improving bone mineral density
- Promoting bowel and bladder function
- Improving tone
- And it has many psychological benefits to clients as well!
If you are interested in learning more, or would like to know if this treatment may be appropriate for you, call our clinic today!!
References
Aaslund, M. K., & Moe-Nilssen, R. (2008). Treadmill walking with body weight support Effect of treadmill, harness and body weight support systems. Gait & Posture, 28, 303-308.
Barbeau, H., & Visintin, M. (2003). Optimal outcomes obtained with body-weight support combined with treadmill training in stroke subjects. Arch Phys Med Rehabil, 84, 1458- 1465.
Burnfield, J. M., Buster, T. W., Goldman, A. J., Corbridge, L. M., & Harper-Hanigan, K. (2016). Partial body weight support treadmill training speed influences paretic and non-paretic leg muscle activation, stride characteristics, and ratings of perceived exertion during acute stroke rehabilitation. Human Movement Science, 47(Supplement C), 16-28. doi:https://doi.org/10.1016/j.
Cramer, S. C., Sur, M., Dobkin, B. H., Brien, C., Sanger, T. D., Trojanowski, J. Q., . . . Vinogradov, S. (2011). Harnessing neuroplasticity for clinical applications. Brain, 134(6), 1591-1609.
Dietz, V. (2009). Body weight supported gait training: from laboratory to clinical setting. Brain Res Bull, 78(1), I-VI. doi:S0361-9230(08)00410-3
Dobkin, B., Apple, D., Barbeau, H., Basso, M., Behrman, A., Deforge, D., . . . Scott, M. (2006). Weight-supported treadmill vs over-ground training for walking after acute incomplete SCI. Neurology, 66(4), 484-493.
Hedel, H. v., Tomatis, L., & Muller, R. (2006). Modulation of leg muscle activity and gait kinematics by walking speed and bodyweight unloading. Gait & Posture, 24, 35-45.
Mehrholz, J., Pohl, M., & Elsner, B. (2014). Treadmill training and body weight support for walking after stroke. Cochrane Database of Systematic Reviews(1). doi:10.1002/14651858.CD002840.
Image Taken From: www.litegait.com
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