The Influence of Applying Additional Weight to the Affected Leg on Gait Patterns During Aquatic Treadmill Walking in People Poststroke

I can't see any use for this. The number of hospitals that can afford and use an underwater treadmill has to be miniscule. You would first need a pool, then buy a very expensive treadmill that works underwater. Or you get the self enclosed pool around the treadmill, still expensive.  But the research was done for whatever reason, so we have to deal with it. A direct result of absolutely NO STROKE STRATEGY LEADING TO 100% RECOVERY.  Aren't you glad we have NO stroke leadership? But the NSA says stroke is beatable, maybe they should actually talk to a few survivors and get the hell out of their bubble.

Options here:

• underwater treadmill (6 posts)

 

The Influence of Applying Additional Weight to the Affected Leg on Gait Patterns During Aquatic Treadmill Walking in People Poststroke

ORIGINAL ARTICLE
The Influence of Applying Additional Weight to the Affected Leg on Gait Patterns During Aquatic Treadmill Walking in People Poststroke
Taeyou Jung, PhD, ATC, DoKyeong Lee, MS, Charalambos Charalambous, MS, Konstantinos Vrongistinos, PhD

ABSTRACT. 

Jung T, Lee D, Charalambous C, VrongistinosK. The influence of applying additional weight to the affected leg on gait patterns during aquatic treadmill walking in peoplepoststroke. Arch Phys Med Rehabil 2010;91:129-36.
Objective:
 To investigate how the application of additional weights to the affected leg influences gait patterns of people poststroke during aquatic treadmill walking.
Design:
Comparative gait analysis.
Setting:
 University-based aquatic therapy center.
Participants:
Community-dwelling volunteers (n

22) with chronic hemiparesis caused by stroke.
Interventions:
 Not applicable.
Main Outcome Measures:
 Spatiotemporal and kinematic gait parameters.
Results:
The use of an ankle weight showed an increase inthe stance phase percentage of gait cycle (3%,
 P

.015) when compared with no weight. However, the difference was not significant after a Bonferroni adjustment was applied for a more stringent statistical analysis. No significant differences were found in cadence and stride length. The use of an ankle weight showed a significant decrease of the peak hip flexion(7.9%,
P

.001) of the affected limb as compared with no weight condition. This decrease was marked as the reduction of unwanted limb flotation because people post stroke typically show excessive hip flexion of the paretic leg in the late swing phase followed by fluctuating hip movements during aquatic treadmill walking. The frontal and transverse plane hip motions did not show any significant differences but displayed a trend of a decrease in the peak hip abduction during the swing phase with additional weights. The use of additional weight did not alter sagittal plane kinematics of the knee and ankle joints.
Conclusions:
 The use of applied weight on the affected limb can reduce unwanted limb flotation on the paretic side during aquatic treadmill walking. It can also assist the stance stability by increasing the stance phase percentage closer to 60% of gait cycle. Both findings can contribute to the development of more efficient motor patterns in gait training for people post stroke.The use of a cuff weight does not seem to reduce the limb circumduction during aquatic treadmill walking.
Key Words:
 Exercise therapy; Gait; Hemiparesis; Rehabilitation; Stroke.©
 2010 by the American Congress of Rehabilitation Medicine

How Rehab Hospital’s Zero Gravity System Helps Stroke Victims

I would call her up and ask very very specifically what the efficacy of this rehab is and how many hours to get to that efficacy. No knowledge means they don't have any fucking clue how it works or how to use it properly. And would the water treadmill be better? 

underwater treadmill

Or the air pressure treadmill?

Air pressure treadmill instantly sheds 80% of your weight

I hated the zero gravity ones because by taking off the weight the spasticity in my legs made walking that much worse.  So ask her what the objective diagnosis starting point for people that this will work for. If there is no starting diagnosis then they are just throwing rehab at patients and hoping some will stick.

 

 

How Rehab Hospital’s Zero Gravity System Helps Stroke Victims

By FBN on August 2, 2019 in Columnists

Stroke is one of the leading causes of death in the United States. When a stroke doesn’t take a life, it often leaves a person’s life changed forever, suffering from short-term and/or long-term mental and physical deficits. Though each person’s post-stroke conditions are unique, many experience loss of movement, balance, coordination, loss of memory and other cognitive or physical functions.
Following a stroke, rehabilitation is the most important factor in determining recovery and long-term outcomes.　Rehabilitation focuses on retraining the brain and the body and can help stroke victims regain their independence and live the highest quality of life possible.
However, one of the biggest forces patients face during the recovery process is gravity. The weight, even just an arm or leg, of a patient’s own body can be one of the biggest challenges of recovery after a stroke.
Gravity and body weight makes recovery more difficult for stroke and brain injury survivors because muscles are weak, balance is shaky and gravity is constantly pulling downward. Those who lack neuromuscular control because of a stroke, brain injury, orthopedic surgery or other conditions cannot always counteract this force.
Fortunately, state-of-the-art rehabilitation equipment is now being used to create less-weight, zero-gravity conditions. This technology aims to reduce the gravitational pull and force on the body. Less gravity (just think of the astronauts on the Moon) makes it easier to move, use and retrain the muscles. Recovery can start to happen much more quickly and fully.
Anti-gravity technology provides advanced exercise and functional-task therapies for rehabilitation. These systems are a great solution for stroke patients who are looking to regain mobility and focused movement, develop strength and increase range of motion and natural movement – all while minimizing stress on the mind and body.
Unlike traditional treadmills that require some amount of stability, strength and coordination to use, the anti-gravity approach lets patients with little to no strength and balance start redeveloping muscles, without fear of falling.
Anti-gravity machines are a great tool for rehabilitation experts such as physical and occupational therapists because they provide a no-barrier, hands-on, safe way to guide patients’ recovery and to precisely track progress. And, because these machines make it easier and safer for unstable patients, most patients report feeling more engaged and motivated during rehab.

How the ZeroG Gait and Balance System Works
ZeroG’s robotic, body-weight support system is mounted to a motorized trolley that rides along an overhead track. The lifting system removes some or all of a patient’s body weight, making it easier for weak muscles to relearn walking, standing, sitting and other basic tasks and functions.
To begin therapy, a therapist secures a patient into a comfortable harness that is attached to the ZeroG robot. The amount of support is individualized for each patient, depending upon the patient’s ability and strength.
Because ZeroG prevents falls, it can provide patients with greater confidence during therapy. Systems like the ZeroG help patients feel successful as they progress back to functional tasks they could do before the stroke, injury, surgery or illness.
Some of the therapeutic activities that ZeroG can be used for include walking, balance exercises, sit-to-stand transitions, walking up and down stairs or over uneven terrain, stepping over floor obstacles, reaching and using assistive devices such as canes, walkers or crutches.
Patients with the following conditions may be able to use the ZeroG treatment: strokes, balance disorders, orthopedic injuries, traumatic brain injuries, spinal cord injuries, amputation, paralysis, Cerebral Palsy, Multiple Sclerosis, Muscular Dystrophy, Parkinson’s disease, neurological injuries, cardiac patients in early recovery and more.
The highest quality rehabilitation care is available right here in Northern Arizona – no need to leave home. The Rehabilitation Hospital of Northern Arizona, which is a part of the Ernest Health system, is the only rehabilitation hospital in the region, serving all of Northern Arizona.
Located in Flagstaff on McMillian Mesa, the 40-bed rehabilitation hospital provides intensive rehabilitation services to people recovering from disabling diseases or injuries, such as strokes, brain, spinal cord and orthopedic injuries. Short-term rehab focuses on rebuilding strength, retraining muscles, regaining speech and rewiring the brain. Treatment plans are individualized and all patients participate in a minimum of three hours of physical, speech and occupational therapy a day. FBN
By Sydnie Bahl, PT, DPT, DPO
For more information, visit　rhna.ernesthealth.com, call 928-774-7070, and/or follow on Facebook at Rehabilitation Hospital of Northern Arizona.
Sydnie Bahl, P.T., D.P.T., is the director of therapy operations at the Rehabilitation Hospital of Northern Arizona.

Robotic gait trainer in water: Development of an underwater gait-training orthosis

I bet you never saw or heard of this from your doctor. Only 8 years old so you can tell how badly out of date your doctor is. I would call it incompetence.
http://www.tandfonline.com/doi/abs/10.1080/09638280701191826

Tasuku Miyoshi Shibaura Institute of Technology, Saitama; Japan Foundation for Aging and Health, AichiCorrespondencemiyoshi@bpe.se.shibaura-it.ac.jp, Kazuaki Hiramatsu Hitachi Medical Corporation, Chiba, Shin-Ichiro Yamamoto Shibaura Institute of Technology, Saitama, Kimitaka Nakazawa Research Institute of National Rehabilitation Center for Persons with Disabilities, Saitama, Japan & Masami Akai Research Institute of National Rehabilitation Center for Persons with Disabilities, Saitama, Japan

Pages 81-87 | Accepted 01 Dec 2006, Published online: 07 Jul 2009

Pages 81-87

Accepted 01 Dec 2006

Published online: 07 Jul 2009

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• https://doi.org/10.1080/09638280701191826

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Abstract

Purpose. To develop a robotic gait trainer that can be used in water (RGTW) and achieve repetitive physiological gait patterns to improve the movement dysfunctions.
Method. The RGTW is a hip-knee-ankle-foot orthosis with pneumatic actuators; the control software was developed on the basis of the angular motions of the hip and knee joint of a healthy subject as he walked in water. Three-dimensional motions and electromyographic (EMG) activities were recorded in nine healthy subjects to evaluate the efficacy of using the RGTW while walking on a treadmill in water.
Results. The device could preserve the angular displacement patterns of the hip and knee and foot trajectories under all experimental conditions. The tibialis anterior EMG activities in the late swing phase and the biceps femoris throughout the stance phase were reduced whose joint torques were assisted by the RGTW while walking on a treadmill in water.
Conclusion. Using the RGTW could expect not only the effect of the hydrotherapy but also the standard treadmill gait training, in particular, and may be particularly effective for treating individuals with hip joint movement dysfunction.

MIT-Skywalker: considerations on the Design of a Body Weight Support System

Once again researchers not keeping up with research in their field. There are water and air pressure treadmills out there. YOU are going to have to test them on your own since your doctor will never find out about them.

underwater treadmill

Air pressure treadmill instantly sheds 80% of your weight

 

https://jneuroengrehab.biomedcentral.com/articles/10.1186/s12984-017-0302-6

• Rogério Sales GonçalvesEmail author and
• Hermano Igo Krebs

Journal of NeuroEngineering and Rehabilitation201714:88

https://doi.org/10.1186/s12984-017-0302-6

©  The Author(s). 2017

Received: 4 October 2016

Accepted: 30 August 2017

Published: 6 September 2017

Abstract

Background

To provide body weight support during walking and balance training, one can employ two distinct embodiments: support through a harness hanging from an overhead system or support through a saddle/seat type. This paper presents a comparison of these two approaches. Ultimately, this comparison determined our selection of the body weight support system employed in the MIT-Skywalker, a robotic device developed for the rehabilitation/habilitation of gait and balance after a neurological injury.

Method

Here we will summarize our results with eight healthy subjects walking on the treadmill without any support, with 30% unloading supported by a harness hanging from an overhead system, and with a saddle/seat-like support system. We compared the center of mass as well as vertical and mediolateral trunk displacements across different walking speeds and support.

Results

The bicycle/saddle system had the highest values for the mediolateral inclination, while the overhead harness body weight support showed the lowest values at all speeds. The differences were statistically significant.

Conclusion

We selected the bicycle/saddle system for the MIT-Skywalker. It allows faster don-and-doff, better centers the patient to the split treadmill, and allows all forms of training. The overhead harness body weight support might be adequate for rhythmic walking training but limits any potential for balance training.

Aquatic treadmill walking may increase exercise capacity after stroke

And how many stroke departments do you think have this? I'd say none except for this one. The hospital I was at gave up their pool years before.Useless because 10 or so people might be able to take advantage when there are 10 million yearly stroke survivors.

Aquatic treadmill walking may increase exercise capacity after stroke

For patients in rehabilitation after a stroke, walking on an underwater treadmill produces better measures of exercise performance compared to conventional treadmill walking, reports a study in the American Journal of Physical Medicine & Rehabilitation.

"Aquatic treadmill exercise may be a useful option for early intensive aerobic exercise after subacute stroke, as it may both improve their aerobic capacity and maximize functional recovery," according to the preliminary research by Bo Ryun Kim, MD, PhD, and colleagues of Jeju National University Hospital, Korea.

Walking in Water May Have Advantages for Post-Stroke Rehab
The study included 21 patients recovering after a stroke—average time since their stroke was about two months. All patients had some walking ability, but with impaired leg movement on the side affected by the stroke.
The patients underwent two exercise tests: one on a conventional land treadmill and one on an aquatic treadmill, submerged in water up to their chests. In both tests, walking speed and slope were gradually increased until the patients felt they couldn't go any further. Measures of exercise capacity were compared between the two tests.Two key measures were higher on the aquatic treadmill test: maximal oxygen consumption (VO2max), reflecting heart and lung function during exercise; and metabolic equivalents (METs), reflecting energy use. Heart rate was not significantly different, but was significantly related to oxygen consumption on both tests.
Even though their exercise performance was higher on the water treadmill, patients felt they weren't working as hard as on the land treadmill, based on a measure called rating of perceived exertion. "This improved performance may reflect the fact that the aquatic treadmill exercise involved the fluid resistance of the water environment," Dr. Kim and colleagues write.
Regaining walking ability is a major challenge after a stroke. Because it's so difficult to walk, patients may be physically inactive, further their reducing exercise capacity. This suggests that early intensive aerobic exercise training might be beneficial in the early weeks after stroke. Treadmill walking is commonly recommended, but may be difficult or impossible because of decreased muscle power.
"The fact that the aquatic treadmill efficiently provides aerobic exercise without requiring full weight bearing means that it may be highly suitable for rehabilitation after stroke," according to the authors. The buoyancy provided by water reduces musculoskeletal impact while allowing combined aerobic and resistance exercise. Exercising in water also has the psychological benefit of freedom from the fear of falling.
The preliminary study is the first to explore the benefits of aquatic treadmill exercise for stroke patients. Further research will be needed to determine whether this approach leads to lasting improvements in exercise capacity and walking ability, several months after the stroke.
If so, then rehabilitation approaches including underwater treadmill exercise may help to overcome the low aerobic capacity seen in stroke survivors—which can contribute to decreased social activity and poor quality of life. Dr. Kim and colleagues conclude, "Aquatic treadmill exercise may not only improve baseline functional status and functional recovery during the subacute period, it may also enhance social participation and quality of life during the chronic stroke period."

Explore further: Treadmill exercise retrains brain and body of stroke victims

More information: Yong Ki Lee et al. Peak Cardiorespiratory Responses of Patients with Subacute Stroke During Land and Aquatic Treadmill Exercise, American Journal of Physical Medicine & Rehabilitation (2016). DOI: 10.1097/PHM.0000000000000603

Journal reference: Archives of Physical Medicine and Rehabilitation
 

Underwater treadmill

This may be for dogs, but the closest I ever came to walking normally was in the pool where the friction of the water caused my left leg to actually  go in a straight line on the step forward. Reduced my spasticity considerably.  Bet your stroke department has nothing but a standard treadmill. Not a split-belt treadmill, or the air pressure treadmill, or a rotating treadmill,or the treadmill bike ?
And this one already exists -

underwater treadmill

Dog underwater treadmill
Does your stroke department know about any of these non-standard treadmills? That answer will tell you how fucking incompetent they are. That should be a fireable offense for the stroke department head.

underwater treadmill

I could have so used this when I was in the hospital except that due to cost-cutting they closed the therapeutic pool. Fake walking in a pool is the only way my affected side stride looks pretty good. I would be running by now if this had been available. Falls in the pool could be injury free.
Ask your doctor why they don't have this.
You don't even need a pool for these;