https://jneuroengrehab.biomedcentral.com/articles/10.1186/s12984-018-0380-0#Bib1
- Salil Apte,
- Michiel Plooij and
- Heike ValleryEmail author
Journal of NeuroEngineering and Rehabilitation201815:53
© The Author(s) 2018
- Received: 5 September 2017
- Accepted: 30 April 2018
- Published: 20 June 2018
The
Correction to this article has been published in Journal of NeuroEngineering and Rehabilitation 2018 15:73
Abstract
Background
Body weight support (BWS) systems have
shown promise as rehabilitation tools for neurologically impaired
individuals. This paper reviews the experiment-based research on BWS
systems with the aim: (1) To investigate the influence of body weight
unloading (BWU) on gait characteristics; (2) To study whether the
effects of BWS differ between treadmill and overground walking and (3)
To investigate if modulated BWU influences gait characteristics less
than unmodulated BWU.
Method
A systematic literature search was
conducted in the following search engines: Pubmed, Scopus, Web of
Science and Google Scholar. Statistical analysis was used to quantify
the effects of BWU on gait parameters.
Results
54 studies of experiments with healthy
and neurologically impaired individuals walking in a BWS system were
included and 32 of these were used for the statistical analysis.
Literature was classified using three distinctions: (1) treadmill or
overground walking; (2) the type of subjects and (3) the nature of
unloading force. Only 27% studies were based on neurologically impaired
subjects; a low number considering that they are the primary user group
for BWS systems. The studies included BWU from 5% to 100% and the 30%
and 50% BWU conditions were the most widely studied. The number of
participants varied from 1 to 28, with an average of 12. It was seen
that due to the increase in BWU level, joint moments, muscle activity,
energy cost of walking and ground reaction forces (GRF) showed higher
reduction compared to gait spatio-temporal and joint kinematic
parameters. The influence of BWU on kinematic and spatio-temporal gait
parameters appeared to be limited up to 30% unloading. 5 gait
characteristics presented different behavior in response to BWU for
overground and treadmill walking. Remaining 21 gait characteristics
showed similar behavior but different magnitude of change for overground
and treadmill walking. Modulated unloading force generally led to less
difference from the 0% condition than unmodulated unloading.
Conclusion
This review has shown that BWU
influences all gait characteristics, albeit with important differences
between the kinematic, spatio-temporal and kinetic characteristics. BWU
showed stronger influence on the kinetic characteristics of gait than on
the spatio-temporal parameters and the kinematic characteristics. It
was ascertained that treadmill and overground walking can alter the
effects of BWU in a different manner. Our results indicate that
task-specific gait training is likely to be achievable at a BWU level of
30% and below.
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