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Baylor Institute for Rehabilitation (BIR) therapists are exploring the effects of body-weight supported locomotor treadmill training in stroke patients. “Traditionally, we’d have stroke patients walk around a parallel bar in a circle, holding on with their strong side while a therapist supported the weak side. It’s better than nothing, but the speed is really slow, nowhere near walking speed,” says Shawn Baker, P.T., DPT, with the BIR physical therapy department. There is also a lot of compensatory movement, such as hyperextension of the knee on the weak side, and patients tend to develop asymmetrical gait patterns.
Locomotor treadmill training is different. Patients walk on a treadmill hooked up to a device that resembles a parachute harness. Using the device, therapists are able to take off as much body weight—usually starting with 30 percent—as necessary to allow patients to walk.
Patients start by walking at 0.7 mph for two sets of three minutes each. “They’re kind of suspended over the treadmill, in part by the machine, but they are having to hold up the remaining two-thirds of their weight. We show them this is safe. Patients can’t fall because the harness is holding them up,” Baker says.
One of the advantages of this system, according to Baker, is it frees the therapist’s hands to better and more comfortably work with patients on gait quality, posture and stance. BIR researchers have already discovered that stroke patients who use locomotor treadmill training with partial body weight support have a better gait and can walk farther and faster than if they had undergone traditional rehabilitation. Studies of the use of locomotor treadmill training following stroke are ongoing at BIR.
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