Ground reaction forces during level ground walking with body weight unloading

Background: Partial body weight support (BWS) systems have been broadly used with treadmills as a strategy for gait training of individuals with gait impairments. Considering that we usually walk on level ground and that BWS is achieved by altering the load on the plantar surface of the foot, it would be important to investigate some ground reaction force (GRF) parameters in healthy individuals walking on level ground with BWS to better implement rehabilitation protocols for individuals with gait impairments. Objective: To describe the effects of body weight unloading on GRF parameters as healthy young adults walked with BWS on level ground. Method: Eighteen healthy young adults (27±4 years old) walked on a walkway, with two force plates embedded in the middle of it, wearing a harness connected to a BWS system, with 0%, 15%, and 30% BWS. Vertical and horizontal peaks and vertical valley of GRF, weight acceptance and push-off rates, and impulse were calculated and compared across the three experimental conditions. Results: Overall, participants walked more slowly with the BWS system on level ground compared to their normal walking speed. As body weight unloading increased, the magnitude of the GRF forces decreased. Conversely, weight acceptance rate was similar among conditions. Conclusions: Different amounts of body weight unloading promote different outputs of GRF parameters, even with the same mean walk speed. The only parameter that was similar among the three experimental conditions was the weight acceptance rate. .

Influence of body weight unloading and support surface during walking of children with cerebral palsy / Influência do alívio de peso corporal e da superfície de suporte durante o andar de crianças com paralisia cerebral espástica

Introduction Partial body weight support (BWS) systems have been employed for gait training of children with cerebral palsy (CP). Therefore, it would be important to analyze if the type of walking surface and the amount of body weight unloading over lower limbs change the way these children walk. Objectives Investigate the influence of walking surface and amount of body weight unloading on the spatial temporal characteristics during walking of children with CP. Materials and methods Seven children with spastic CP between four and eight years old and GMFCS (Gross Motor Function Classification System) between I and IV, were videotaped walking with 0%, 15% and 30% of BWS on both dynamic (treadmill) and static (ground level) surfaces. Walking spatial temporal variables were calculated. Results Children walked with similar velocity in all experimental conditions. While stance duration decreased as the percentage of BWS increased, no differences were found for stance and swing periods and cadence. Children walked with longer steps and strides and with faster strides on static surface compared to dynamic surface. Conclusion Children with CP presenting different levels of motor impairment presented some alterations in the spatial temporal walking parameters as they walked with body unloading. However, such alterations might be due mainly to the type of walking surface than the percentage of body weight unloading on lower limbs.

Introdução Sistemas de suporte parcial de peso corporal (SPPC) têm sido utilizados para treinamento do andar de crianças com paralisia cerebral (PC). Sendo assim, seria importante analisar se o tipo de superfície e a quantidade de alívio de peso corporal sobre os membros inferiores interferem na forma como essas crianças andam. Objetivo Investigar a influência do tipo de superfície e da porcentagem de alívio de peso corporal sobre as características espaço-temporais durante o andar de crianças com PC. Materiais e métodos Sete crianças com PC espástica, entre quatro e oito anos de idade, e GMFCS (Gross Motor Function Classification System) entre I e IV, foram filmadas andando com 0%, 15% e 30% de SPPC em superfícies móvel (esteira motorizada) e fixa (chão). Variáveis espaço-temporais do andar foram calculadas. Resultados As crianças andaram com velocidade semelhante em todas as condições experimentais. Enquanto que a duração do período de apoio diminuiu conforme a porcentagem de SPPC aumentou, nenhuma diferença para as fases de apoio e balanço e cadência foi encontrada. As crianças andaram com passos e passadas mais longos e passadas mais rápidas na superfície fixa do que na superfície móvel. Conclusão Crianças com PC com diferentes níveis de acometimento motor apresentaram algumas alterações nos parâmetros espaço-temporais durante o andar com alívio de peso corporal em superfícies móvel e fixa. Entretanto, tais alterações podem ser atribuídas principalmente ao tipo de superfície em que as crianças andam do que às porcentagens de alívio de peso corporal proporcionadas aos membros inferiores.

Partial Body Weight Support on Walking Ability for Stroke Following Hemiplegia at Early Stage / 中国康复理论与实践

@#ObjectiveTo observe the effect of early partial body weight support on walking ability for stroke patients with hemiplegia.Methods60 stroke patients were divided into 3 groups, receiving conventional early rehabilitation: group A (20 cases) received conventional rehabilitation for 8 weeks; group B (20 cases) received 2 weeks conventional rehabilitaion and 6 weeks partial body weight support; group C (20 cases) received 5 weeks conventional rehabilitaion and 3 weeks partial body weight support. Fugl-Meyer Assessment(FMA), Barther Index(BI) and Berg Balance Scale(BBS) were used to assess the effect before and after treatment.ResultsThe socres of FMA, BI and BBS improved in walking function after the treatment(P<0.05). Comparing with groups A and C, group B improved more significantly after treatment (P<0.05), and group C was better than group A (P<0.05). ConclusionPartial body weight support can improve walking function of hemiplegic patients at early stage.

Effects of Partial Body Weight Support Treadmill Training on Sequela of Stroke / 中国康复理论与实践

@#Objective To explore the effects of partial body weight support treadmill training (PBWSTT) on motor function of lower extremities, walking ability and activities of daily living (ADL) in chronic hemiplegic patients after stroke. Methods28 patients with stable stroke (hemiplegic limbs Brunstrom s' scale≥Ⅲ) exceed 12 months after the onset were divided into PBWSTT group (n=14) and control group (n=14) randomly. Routine rehabilitation were used in the control group, and the PBWSTT group received PBWSTT in addition. They were assessed with Ashworth Spasticity Scale （ASS）, Functional Ambulation Category (FAC), Fugl-Meyer Assessment (FMA), and the Functional Independence Measurement (FIM) before and 8 weeks after the treatment. ResultsThe ASS,FAC, FMA and FIM scores were all improved after treatment in both groups (P<0.05). The scores of FMA, FAC and FIM in the PBWSTT group after treatment exceeded that of control group (P<0.05), but there was no difference in the ASS (P>0.05). ConclusionPBWSTT may improve the motor function of lower extremities, walking ability, and ADL in chronic hemiplegic patients after stroke.

Effect of Partial Body Weight Support Training on Cerebral Palsy Children with Spasticity Diplegia / 中国康复理论与实践

@#Objective To observe the effect of partial body weight support training (PBWST) on walking ability of cerebral palsy (CP) children with spasticity diplegia.Methods 60 CP children with spasticity dilegia were randomly divided into the PBWST group and control group with 30 cases in each group. All cases were treated by traditional physical treatment, but those of the PBWST group were added with PBWST. The changes of walking ability and endurance of all cases before and after treatment were observed.Results After treatment, the walking ability and endurance of the cases in two groups improved significantly, but the effect of the PBWST group was obviously superior to the control group ( P<0.05), especially in walking endurance ( P<0.001).Conclusion PBWST can improve the walking ability of CP children with spasticity diplegia and already having walking ability.

Effect of partial body-weight support and treadmill training on lower extremities functional of subacute stroke patients / 中国康复理论与实践

@#ObjectiveTo study the effect of partial body-weight support and treadmill training in subacute stroke patients.Methods40 stroke patients were randomly arranged into 3 groups: group A (n=14) accepted 8 weeks of routine physical therapy, group B (n=13) accepted additional 6 weeks partial body-weight support and treadmill training at the 3rd week, group C (n=13) accepted additional 3 weeks partial body-weight support and treadmill training at the 6th week. The patients were evaluated with Fugl-Meyer Assessment of Physical Performance(FMA), Barthel Idex(BI) and the Berg Balance Scale(BBS). ResultsThe functional outcome of the initial evaluation with FMA, BI and BBS were no-significantly different, 8 weeks later, that of group B were better than that of group A and group C (P<0.05～0.01), and that of group C were better than that of group A (P<0.05).ConclusionEarly treatment of partial body-weight support and treadmill training can help to improve the lower extremities function.