Body-Weight Supported Treadmill Training (BWSTT)
Our definition of body weight support treadmill training (BWSTT) can be found above in Section 3.0 on Cardiorespiratory Health and Endurance.
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Author Year Country Score |
Methods |
Outcome |
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Turiel et al. (2011) Italy Pre-Post N=14
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Population: SCI Group: Mean age 50.6 ± 17.1yr; Gender: males=10, females=4; 2-10yr post-injury; 9 paraplegia) with lost sensorimotor function caused by incomplete SCI. Intervention: BWSTT assisted with robotically driven gait orthosis for 60 min sessions, 5 d/wk, 6wk, with 30-50% of body weight supported (reduced as tolerated). Outcome Measures: Left ventricular function, coronary blood flow reserve (via dipyridamole stress echo), plasma asymmetric dimethylarginine (ADMA) (a marker of vascular abnormalities observed in cardiovascular disease and aging), and plasma inflammatory markers. |
· Significant improvement in the left ventricular diastolic function (i.e., a reduction in isovolumic relaxation time and deceleration time was observed following the training. · Significant ↑ in coronary reserve flow and reduced plasma ADMA levels were observed in the follow-up. · Significant reduction in the inflammatory status (C-reactive protein and erythrocyte sedimentation rate). |
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Phillips et al. (2004) Canada Pre-Post N=9
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Population: 8 male, 1 female, incomplete AIS C, C4-T12, 8.1 yrs post-injury. Intervention: Body-weight–supported treadmill walking, 3 d/wk, 6 months. Outcome Measures: whole-body dual-energy X-ray absorptiometry (to capture body composition and bone density), GLUT4 protein abundance, hexokinase activity, oral glucose tolerance tests, glucose oxidation, CO2 breath analysis. |
· Reduction in the area under the curve for glucose (-15%) and insulin (-33%). · The oxidation of exogenous (ingested) glucose and endogenous (liver) glucose ↑ (68% and 36.8%, respectively) after training. · Training resulted in ↑ muscle glycogen, GLUT-4 content (glucose transporter) (126%), and hexokinase II enzyme activity (49%). |
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Stewart et al. (2004b) Canada Pre-Post N=9 |
Population: 8 male, 1 female, incomplete AIS C, C4-T12, 8.1yr post-injury. Intervention: Body-weight–supported treadmill training, 3 d/wk, 6 months. Outcome Measures: ambulatory capacity (Wernig Walking Scale), cholesterol, HDL, LDL, triglycerides. |
· There were significant reductions in TC (-11.2%), LDL (-12.9%), and TC/HDL (-19.8%). |
Discussion
Three pre-post studies have investigated the role of BWSTT on cardiometabolic function. All 3 studies demonstrate level 4 evidence that BWSTT improves various markers of cardiometabolic function including reduced insulin levels, reduced HOMA-IR, improved lipids, and reduced inflammation.
Conclusion
There is level 4 evidence (Turiel et al. 2011) that 6 weeks of 5d/wk BWSTT (60 min/day, 50-60% weight support) improves cardiac diastolic function and reduces inflammation in individuals with incomplete paraplegia.
There is level 4 evidence (Phillips et al. 2004) that 6 months of 3d/wk BWSTT improves glucose tolerance and increases GLUT-4 muscle content in individuals with various levels and severities of SCI.
There is level 4 evidence (Stewart et al. 2004b) that 6 months of 3d/wk improves blood lipids in individuals with various levels and severities of SCI.
