Using body weight gait training on me didn't work. I needed the full body weight to counteract the spasticity. Lokomat training did work since it forced the spasticity into submission. My doctor however thought Lokomats were not useful. He didn't discuss it with me.
Gait training with partial body weight support during overground walking for individuals with chronic stroke: a pilot study
Catarina O Sousa1
, José A Barela
2,3
, Christiane L Prado-Medeiros
1
, Tania F Salvini
1
and Ana MF Barela
3*
Abstract
Background:
It is not yet established if the use of body weight support (BWS) systems for gait training is effectiveper 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 over ground walking with no BWS.
Methods:
Twelve individuals with chronic stroke (53.17 ± 7.52 years old) participated of a gait training program with BWS during over ground 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.
Results:
After 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.
Conclusions:
Gait training individuals with chronic stroke with BWS during over ground 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.
Background
Typically, individuals with stroke walk slower than their peers and present asymmetry in spatial-temporal para-meters [1,2] and joint angles [3]. These typical characteristics may influence the return of pre-stroke conditions [4], mainly because there exists an increased risk of falling [5], followed by decreases in autonomy, and consequently, an increase in social isolation [6,7]. Therefore, reestablishing independence via walking is a crucial goal of any rehabilitation program for individuals with stroke [3,4,8]. Among the different strategies of gait training for individuals with stroke, the use of a partial body weight sup-port (BWS) system has continued to gain popularity [9-13]. 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 loco-motor 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 over ground [9] or when using only a treadmill [10].A BWS system alleviates the body weight of the lower limbs symmetrically [10,18,19], promotes stabilization of the trunk [20], improves balance control, and avoids falls [16].
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