Treadmill Training with Partial Body Weight Support: Influence of Body Weight Release on the Gait of Hemiparetic Patients

Abstract

Objective: To investigate the effect of body weight support on the gait of hemiparetic subjects walking on a treadmill. Design: Survey. Patients: Eleven nonambulatory hemi paretic subjects. Methods: Subjects walked on the treadmill with full weight bearing and with 15%, 30%, 45%, and 60% body weight support at constant walking veloc ity. Cycle parameters, symmetry ratios, and the kinematic EMG of several lower limb muscles of the affected leg were recorded. Video-analysis served for assessment of pos ture and hip and knee angle displacement. Results: With body weight support the rel ative double support time decreased, the relative single stance period of the affected limb increased, and the functional activity of the vastus and soleus diminished. The activity of the gluteus tended to increase. Patients walked more upright and with less hip and knee flexion. The extensor spasticity did not change and the qualitative acti vation pattern of all recorded muscles remained unchanged. Conclusion: Body weight support did not facilitate a less physiological gait. By reducing double support dura tion, body weight support resulted in a greater stimulus for balance training. The facil itation of gluteus medius is favorable with respect to training pelvic alignment. The reduction of the activity of other antigravity muscles suggests a limit of 30% BWS not be exceeded. Key Words: Hemiparesis—Gait—Treadmill training.