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Body weight-supported treadmill training after stroke

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Abstract

Gait rehabilitation is a major aspect of neurologic rehabilitation. This review focuses on locomotor therapy by treadmill stimulation with partial body weight support (BWS), which has become a very promising treatment concept over the past few years. It enables severely affected patients to follow modern aspects of motor learning, favoring a task-specific approach. Initially two therapists assist the movement, placing the paretic limbs and controlling the trunk movements. As compared with overground walking, patients walked more symmetrically, less spastically, and more efficiently on the treadmill with BWS. Several clinical controlled studies have shown its potential in patients after stroke, who regained walking ability faster in the acute or in the chronic stage. Controlled multicenter trials comparing locomotor and conventional therapy will be the next step. Also, the use of BWS during overground walking could be incorporated into the locomotor treatment program of less affected stroke patients. An electromechanical gait trainer relieving the strenuous effort of the therapists and controlling the trunk in a phase-dependent manner is a new technical alternative for severe stroke patients.

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References and Recommended Reading

  1. Wade DT, Wood VA, Heller A, et al.: Walking after stroke: measurement and recovery over the first three months. Scand J Rehab Med 1987, 19: 25–30.

    CAS  Google Scholar 

  2. Mauritz KH: General rehabilitation. Curr Opin Neurol 1990, 3: 714–718.

    CAS  Google Scholar 

  3. Hesse S, Jahnke MT, Bertelt C, et al.: Gait outcome in ambulatory hemiparetic patients after a 4-week comprehensive rehabilitation program and prognostic factors. Stroke 1994, 25: 1999–2004.

    PubMed  CAS  Google Scholar 

  4. Asanuma H, Keller A: Neurobiological basis of motor learning and memory. Concepts Neurosci 1991, 2: 1–30.

    Google Scholar 

  5. Carr J, Shepherd R: Neurological Rehabilitation. Oxford: Butterworth & Heinemann; 1998.

    Google Scholar 

  6. Winstein CJ, Gradner ER, McNeal DR, et al.: Standing balance training: effects on balance and locomotion in hemiparetic adults. Arch Phys Med Rehabil 1989, 70: 755–762.

    PubMed  CAS  Google Scholar 

  7. Dean C, Shepherd R: Task-related training improves the performance of seated reaching tasks following stroke: a randomized controlled trial. Stroke 1997, 28: 722–728.

    PubMed  CAS  Google Scholar 

  8. Kirker SG, Simpson DS, Renner JR, Wing AM: Stepping before standing: hip muscle function in stepping and standing balance after stroke. J Neurol Neurosurg Psychiatry 2000, 68: 458–464.

    Article  PubMed  CAS  Google Scholar 

  9. Langhamer, Stanghelle JK: Bobath or motor relearning programme? A comparison of two different approaches of physiotherapy in stroke rehabilitation: a randomized controlled study. Clin Rehab 2000, 14: 361–369.

    Article  Google Scholar 

  10. Finch L, Barbeau H: Hemiplegic gait: new treatment strategies. Physiother Can 1986, 38: 36–41.

    Google Scholar 

  11. Hesse S, Bertelt C, Schaffrin A, et al.: Restoration of gait in non-ambulatory hemiparetic patients by treadmill training with partial body weight support. Arch Phys Med Rehab 1994, 75: 1087–1093.

    Article  CAS  Google Scholar 

  12. Barbeau H, Wainberg W, Finch L: Description and application of a system for locomotor rehabilitation. Med Biol Eng Comput 1987, 25: 341–344.

    Article  PubMed  CAS  Google Scholar 

  13. Wernig A, Müller S: Laufband locomotion with body weight support improved walking in persons with severe spinal cord injuries. Paraplegia 1992, 30: 229–238.

    PubMed  CAS  Google Scholar 

  14. Dietz V, Colombo G, Jensen L: Locomotor activity in spinal man. Lancet 1994, 344: 1260–1263.

    Article  PubMed  CAS  Google Scholar 

  15. Norman KE, Pepin EA, Ladouceur M, Barbeau H:. A treadmill apparatus and harness support for evaluation and and rehabilitation of gait. Arch Phys Med Rehab 1995, 76: 772–778.

    Article  CAS  Google Scholar 

  16. Gazzani F, Bernardi M, Macaluso A, et al.: Ambulation training of neurological patients on the treadmill with a new walking assistance and rehabilitation device (WARD). Spinal Cord 1997, 37: 336–344.

    Article  Google Scholar 

  17. Lovely RG, Gregor RJ, Roy RR, Edgerton VR: Effects of training on the recovery of full weight-bearing stepping in the adult spinal cat. Exp Neurol 1986, 92: 421–435.

    Article  PubMed  CAS  Google Scholar 

  18. Eidelberg E, Walden JG, Nguyen LH: Locomotor control in macaque monkeys. Brain 1981, 104: 647–663.

    Article  PubMed  CAS  Google Scholar 

  19. Andersson O, Grillner S: Peripheral control of the cat’s step cycle. II. Entrainment of the central pattern generators by sinusoidal hip movements during “fictive locomotion”. Acta Physiol Scand 1983, 118: 229–239.

    Article  PubMed  CAS  Google Scholar 

  20. Duysen J, Pearson KG: Inhibition of flexor burst generation by loading ankle extensor muscles in walking cats. Brain Res 1980, 187: 321–332.

    Article  Google Scholar 

  21. Hesse S, Bertelt C, Jahnke MT, et al.: Treadmill training with partial body weight support as compared to physiotherapy in non-ambulatory hemiparetic patients. Stroke 1995, 26: 976–981.

    PubMed  CAS  Google Scholar 

  22. Hesse S, Malezic M, Schaffrin A, Mauritz KH: Restoration of gait by a combined treadmill training and multichannel electrical stimulation in non-ambulatory hemiparetic patients. Scand J Rehab Med, 1995, 27: 199–205.

    CAS  Google Scholar 

  23. Jorgensen HS, Nakayama H, Raaschou HO, Olsen TS: Recovery of walking function in stroke patients: the Copenhagen stroke study. Arch Phys Med Rehabil 1995, 76: 27–32.

    Article  PubMed  CAS  Google Scholar 

  24. Visintin M, Barbeau H, Korner-Bitensky N, Mayo NE: A new approach to retrain gait in stroke patients through body weight support and treadmill stimulation. Stroke 1998, 29: 1122–1128.

    PubMed  CAS  Google Scholar 

  25. Kosak MC, Reding MJ: Comparison of partial body weight-supported treadmill gait training versus aggressive bracing assisted walking post stroke. Neurorehabil Neural Repair 2000, 14: 13–19.

    Article  PubMed  CAS  Google Scholar 

  26. Hesse S, Helm B, Krajnik J, et al.: Treadmill training with partial body weight support: influence of body weight release on the gait of hemiparetic patients. J Neurol Rehab 1997, 11: 15–20.

    Google Scholar 

  27. Hassid E, Rose D, Commisarow J, et al.: Improved gait symmetry in hemiparetic stroke patients during body weight-supported treadmill stepping. J Neurol Rehab 1997, 11: 21–26.

    Google Scholar 

  28. Hesse S, Konrad M, Uhlenbrock D: Treadmill walking with partial body weight support versus floor walking in hemiparetic subjects. Arch Phys Med Rehabil 1999, 80: 421–427.

    Article  PubMed  CAS  Google Scholar 

  29. Danielsson A, Sunnerhagen KS: Oxygen consumption during treadmill walking with and without body weight support in patients with hemiparesis after stroke and in healthy subjects. Arch Phys Med Rehabil 2000, 81: 953–957.

    Article  PubMed  CAS  Google Scholar 

  30. Hesse S, Werner C, Paul T, Bardeleben A, Chaler J: The influence of walking speed on lower limb muscle activity and energy consumption during treadmill walking of hemiparetic patients. Arch Phys Med Rehabil 2001, in press.

  31. Macko RF, DeSouza CA, Tretter LD, et al.: Treadmill aerobic exercise training reduces the energy expenditure and cardiovascular demands of hemiparetic gait in chronic stroke patients. A preliminary report. Stroke 1997, 28: 326–330.

    PubMed  CAS  Google Scholar 

  32. Hesse S, Sarkodie-Gyan T, Uhlenbrock D: Development of an advanced mechanised gait trainer, controlling movement of the centre of mass, for restoring gait in non-ambulatory subjects. Biomed Tech 1999, 7: 194–201.

    Google Scholar 

  33. Hesse S, Werner C, Uhlenbrock D, et al.: An electromechanical gait trainer for restoration of gait in hemiparetic stroke patients: preliminary results. Neurorehabil Neural Repair 1999, 13: 157–165.

    Article  Google Scholar 

  34. Colombo G, Joerg M, Schreier R, Dietz V: Treadmill training of paraplegic patients using a robotic orthosis. J Rehabil Res Dev 2000, 37: 313–319.

    Google Scholar 

  35. Fung J, Barbeau H, Roopchard S: Partial weight support improves force generation and postural alignment during overground locomotion following stroke. Neurosci Abstract 1999, 25: 907.

    Google Scholar 

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Hesse, S., Werner, C., Bardeleben, A. et al. Body weight-supported treadmill training after stroke. Curr Atheroscler Rep 3, 287–294 (2001). https://doi.org/10.1007/s11883-001-0021-z

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