The use of body weight support on ground level: an alternative strategy for gait training of individuals with stroke

Catarina O Sousa, José A Barela, Christiane L Prado-Medeiros, Tania F Salvini, Ana M F Barela, Catarina O Sousa, José A Barela, Christiane L Prado-Medeiros, Tania F Salvini, Ana M F Barela

Abstract

Background: Body weight support (BWS) systems on treadmill have been proposed as a strategy for gait training of subjects with stroke. Considering that ground level is the most common locomotion surface and that there is little information about individuals with stroke walking with BWS on ground level, it is important to investigate the use of BWS on ground level in these individuals as a possible alternative strategy for gait training.

Methods: Thirteen individuals with chronic stroke (four women and nine men; mean age 54.46 years) were videotaped walking on ground level in three experimental conditions: with no harness, with harness bearing full body weight, and with harness bearing 30% of full body weight. Measurements were recorded for mean walking speed, cadence, stride length, stride speed, durations of initial and terminal double stance, single limb support, swing period, and range of motion of ankle, knee, and hip joints; and foot, shank, thigh, and trunk segments.

Results: The use of BWS system leads to changes in stride length and speed, but not in stance and swing period duration. Only the hip joint was influenced by the BWS system in the 30% BWS condition. Shank and thigh segments presented less range of motion in the 30% BWS condition than in the other conditions, and the trunk was held straighter in the 30% BWS condition than in the other conditions.

Conclusion: Individuals with stroke using BWS system on ground level walked slower and with shorter stride length than with no harness. BWS also led to reduction of hip, shank, and thigh range of motion. However, this system did not change walking temporal organization and body side asymmetry of individuals with stroke. On the other hand, the BWS system enabled individuals with chronic stroke to walk safely and without physical assistance. In interventions, the physical therapist can watch and correct gait pattern in patients' performance without the need to provide physical assistance.

Figures

Figure 1
Figure 1
Partial view of the body weight support system used in the study. The rail that the electric motor slides along, the load cell, and one of the experimenters wearing the harness are shown.
Figure 2
Figure 2
Ankle, knee, and hip joint angles during the stride cycle. Mean (± SD) stride cycle of ankle, knee, and hip joint angles for the individuals with chronic stroke walking with no harness (A), with 0% BWS (B), and 30% BWS (C) on nonparetic (gray area) and paretic (line) body sides. Positive values denote ankle dorsiflexion, knee and hip flexion, and negative values denote ankle plantar flexion, knee and hip extension (n = 13).
Figure 3
Figure 3
Foot, shank, thigh, and trunk segmental angles during the stride cycle. Mean (± SD) stride cycle of foot, shank, thigh, and trunk segmental angles for the individuals with chronic stroke walking with no harness (A), with 0% BWS (B), and 30% BWS (C) on nonparetic (gray area) and paretic (line) body sides. Positive values denote counter-clockwise (backward) rotation of segments and negative values denote clockwise (forward) rotation of segments (n = 13).

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