Body Weight Treadmill

Question 1

Set-up

Answer 1

harness- essentially a parachute

treadmill-should be specially designed

body weight support system- all work about the same

therapists/helpers- 2 or more

Question 2

BWSTT benefits

Answer 2

1. provides protection from falling
2. triggers and controls the postural system reaction
3. Facilitates reflexive actions
4. controls the balance strategy of stepping
5. rhythmic, symmertrical, bilateral stepping is facilitated
6. allows for controlled cognitive interaction with walking

Question 3

Theories

Answer 3

stepping reaction- as the foot moved and the boy forward the stepping reacion is triggered

central pattern generator- reciprocal motion of walking triggers the affected side to step

neuroplasticity- repeated practice, task specific, and high or variable intensity

Question 4

Goals

Answer 4

normalize gait pattern- stance time, step ength, cadence, muscle activation

normalize walking speed

normalize trunk motion- UE swing, thunk/pelvis rotation

Question 5

Considerations

Answer 5

type and severity of a patient’s neurological situation- cardiovascular, cognition, balance (trunk control very important when using BWSTT), etc

comorbidities- hip replacement (special harness)

Fear

Question 6

Interventions-best practice

Answer 6

assisted stepping- normalizegait as much as possible and lessen assistance as able

encourage arm swing- don’t let the patient hold on

trunk rotation- assist an normalize as much as possible

gait speed- the closer to normal walking speed the better (.3-.5 is a good starting speed)

incline- adding an incline increases the intensity. Harder to step but helps neuroplasticity

Question 7

Research

Answer 7

visintin et al- 79% p CVA returned to FWB community amb. RCT compared BWSTT vs no BWSTT

Sullivan et al- Task specific BWSTT more effective at increasing walking speed than leg cycle. LE strength training alternated c BWSTT did not provide added benefit. RCT

RIC- 1000 steps per day the magic number for improved amb mobility at d/c. Transfers, balance, and gait all improved c BWSTT as compared to those with specific PT for transfers and balance

ASIA C imcomplete has good outcomes. All complete not very good at all-not much help for complete.