PARTIAL BODY WEIGHT SUPPORT TREADMILL TRAINING IMPROVES BALANCE AND GAIT IN A FRAIL OLDER ADULT.

Abstract

Purpose/Hypothesis: Partial body weight support treadmill training (PBWSTT) has been documented to improve balance, walking ability, gait speed, and gait symmetry in people who have experienced a stroke, spinal cord injury, or traumatic brain injury. Given these improvements and the task specific nature of PBWSTT, one question is whether this intervention could have a similar effect in frail older adults at a high risk for falls. By supporting part of the person's body weight, the postural demands of walking are decreased, improving the ability to walk with a normal gait pattern at a desired faster speed. Also, by supporting some of the body weight, the energy demands are decreased, allowing the person to walk for longer distances. This intervention may allow for improvements in gait speed and balance in frail older adults and therefore increase their mobility and decrease their risk for falls. The purpose of this study was to determine the effects of PBWSTT on the balance and gait characteristics of an older adult with a history of falls. Number of Subjects: One. Materials/Methods: A single subject ABAA design with multiple measurements was used. The subject was a 97 year-old female with a history of balance problems and falls. The Berg Balance Scale (BBS), Modified Falls Efficacy Scale (MFES), and the GAITRite computerized gait analysis system were utilized in data collection. The A1 phase consisted of outcome measures gathered four times per week for two weeks to establish a baseline. The B phase, the intervention phase, consisted of PBWSTT three times per week for four weeks with outcome measurements recorded two of three sessions each week. The A2 phase immediately followed the B phase and mirrored the A1 phase. The A3 phase was scheduled to be performed five months after the B phase and mirror the A1 phase. Data was analyzed using the two standard deviation band method, with two consecutive data points outside the band considered a significant change Results: Compared to the A1 phase, the subject demonstrated significant increases in BBS score, velocity, cadence, and stride length, and a significant decrease in base of support in the B and A2 phases. As a result of a change in our subject's medical status during the time between the A2 and A3 phases, data was not collected for the A3 phase. Average BBS scores for the A1, B, and A2 phases were 33.25, 40.5, and 44.8 respectively. Gait speed averaged .61 m/s in the A1 phase, .85 m/s in the B phase, and .84 m/s in the A2 phase. Conclusions: A 97-year-old female with a history of balance deficits and falls was found to tolerate and benefit from a four-week training program of partial body weight support treadmill training as demonstrated by improvements in balance and gait characteristics. These improvements were maintained throughout the two-week follow up. Clinical Relevance: Decreased balance and slower gait speed are associated with falls in older adults. PBWSTT may be an effective intervention to improve balance and gait and decrease the risk for falls.