The ability to walk is most often the primary goal for people following a stroke. Physiotherapists have many skills in their toolbox that they can use to work towards this goal – one of which is body weight support treadmill training.
Body weight support (BWS) is a harness system that supports a percentage of an individuals’ body weight, therefore unloading the lower extremities. The BWS can be used overground or placed over a treadmill.
Using a treadmill allows an individual to walk at a pre-determined speed, and as we say at Advance Rehab Centre ‘the treadmill stops for no one!’ Following a stroke your step length can vary dramatically; usually being shorter on the unaffected leg. This can be due to an inability to take weight and load the effected lower limb.
Evidence has shown that higher intensity of practice, such as more repetitions, results in better outcomes after stroke. Implementation of a treadmill as a treatment modality may be a way of increasing the number of steps taken, therefore leading to a higher intensity of practice.
Studies have been carried out comparing treadmill training with overground walking both with and without BWS with varying results. One study compared treadmill training with and without BWS. Both groups walked on the treadmill with one having 40% BWS and the other without the BWS therefore taking 100% of their weight. This study concluded that the group who used the BWS had a significant increase in overground walking speed, endurance, balance and motor recovery, especially those who were more impaired initially. This study also reported less learnt compensatory strategies with using the BWS. An increase in mobility with BWS treadmill training has been shown in people at different stages after their stroke; both initially and more than 6 months after.
Using the BWS allows the therapist to concentrate on lower limb positioning and foot placement. Many people following a stroke are able to walk quicker on a treadmill with BWS than overground.
There does need to be more research comparing overground walking with and without BWS as well as clearer duration of training to achieve optimum intensity and results.
At Advance Rehab Centre we have a BWS which has been custom built to stand over the treadmill. Our patients often take their first steps in the BWS on the treadmill at the centre.