Gait training with partial body weight support during overground walking for individuals with chronic stroke: a pilot study

Catarina O Sousa,José A Barela,Ana Mf Barela,Christiane L Prado-Medeiros,Tania F Salvini

doi:10.1186/1743-0003-8-48

Abstract

BackgroundIt is not yet established if the use of body weight support (BWS) systems for gait training is effective per se or if it is the combination of BWS and treadmill that improves the locomotion of individuals with gait impairment. This study investigated the effects of gait training on ground level with partial BWS in individuals with stroke during overground walking with no BWS.MethodsTwelve individuals with chronic stroke (53.17 ± 7.52 years old) participated of a gait training program with BWS during overground walking, and were evaluated before and after the gait training period. In both evaluations, individuals were videotaped walking at a self-selected comfortable speed with no BWS. Measurements were obtained for mean walking speed, step length, stride length and speed, toe-clearance, durations of total double stance and single-limb support, and minimum and maximum foot, shank, thigh, and trunk segmental angles.ResultsAfter gait training, individuals walked faster, with symmetrical steps, longer and faster strides, and increased toe-clearance. Also, they displayed increased rotation of foot, shank, thigh, and trunk segmental angles on both sides of the body. However, the duration of single-limb support remained asymmetrical between each side of the body after gait training.ConclusionsGait training individuals with chronic stroke with BWS during overground walking improved walking in terms of temporal-spatial parameters and segmental angles. This training strategy might be adopted as a safe, specific and promising strategy for gait rehabilitation after stroke.

Highlights

It is not yet established if the use of body weight support (BWS) systems for gait training is effective per se or if it is the combination of BWS and treadmill that improves the locomotion of individuals with gait impairment
Post-hoc tests indicated that the step length of the nonparetic side was longer than the step length of the paretic side before gait training, and that after gait training step length of the paretic side became similar to the step length of the nonparetic side
This study investigated the effects of gait training on ground level with partial BWS on temporal-spatial parameters and the lower limb and trunk segmental angles of individuals with chronic stroke during overground walking with no BWS

Summary

Introduction

It is not yet established if the use of body weight support (BWS) systems for gait training is effective per se or if it is the combination of BWS and treadmill that improves the locomotion of individuals with gait impairment. Among the different strategies of gait training for individuals with stroke, the use of a partial body weight support (BWS) system has continued to gain popularity [9,10,11,12,13]. This strategy of gait training originated from experiments on animals with complete spinal cord transections [14,15], which established that training on a treadmill promotes the generation of an automatic locomotor pattern by spinal neurons [16,17], named the central pattern generator. Gait training humans affected by stroke using a BWS system on a treadmill increased walking speed and endurance when compared to conventional gait training overground [9] or when using only a treadmill [10]

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