AA

Body Weight Supported Treadmill Training

A question arises as to whether he would benefit from Body-Weight Supported Treadmill Training (BWSTT) to assist him with relearning to walk again.
Q6.  What is Body-Weight Supported Treadmill Training (BWSTT)?
1. Partial body weight support is provided by a harness suspended from the ceiling or a frame while limb stepping movements are assisted by a moving treadmill belt.

In this approach, partial body weight support is provided by a harness suspended from the ceiling or a frame while limb stepping movements are assisted by a moving treadmill belt. See figure 1 for a picture of a weight-assisted treadmill.


Figure 1.  Image of a weight-assisted treadmill courtesy of StrokEngine (2010). Retrieved from http://www.strokengine.ca/index.php?page=topic&subpage=patient&id=33.

 

Q7.  What evidence is there for BWSTT in Acute/Subacute SCI?

 

1. For patients less than 12 months post-SCI, body weight supported treadmill training has equivalent effects on gait outcomes to conventional rehabilitation consisting of overground mobility practice (Level 3 evidence found: see figure 2 for results of Dobkins et al. 2006).
For more information please see: BWSTT in Acute/Subacute SCI

 

Figure 2.  P-values indicating no statistical significance between treatment group (BWSTT) versus control (over ground practice) at 6 months. Note: B = AIS B; C = AIS C; D = AIS D; UMN = Upper motor neuron; LMN = Lower Motor Neuron; UMN and LMN B, C were tested using Functional Independence Measure locomotor; UMN and LMN C, D were tested for walking speed. Source: Dobkin B, Apple D, Barbeau H, Basso M, Behrman A, Deforge D, Ditunno J, Dudley G, Elashoff R, Fugate L, Harkema S, Saulino M, and Scott M. Weight-supported treadmill vs over-ground training for walking after acute incomplete SCI. Neurology 2006;66: 484-493.

Q8. What evidence is there for BWSTT in Chronic SCI (>1 year post injury)?
1. Body weight-support gait training strategies can improve gait outcomes in chronic, incomplete SCI, but no body weight-support strategy (overground, treadmill, with FES) is more effective (Level 1 and 4 evidence found from pre-test/post-test studies: see figure 3 of Field-Fote et al. 2005).
For more information please see: BWSTT in Chronic SCI

 

Figure 3.  Effect of Body Weight Support Assisted training on walking speed in chronic motor incomplete SCI individuals. Source: Field-Fote EC, Lindley SD, and Sherman AL. Locomotor training approaches for individuals with spinal cord injury: a preliminary report of walking-related outcomes. J Neurol Phys Ther 2005;29: 127-137.