Body Weight Support Treadmill Training – a systematic review of meta-analyses

Marcin Błaszcz, Beata Stach

M.Błaszcz, B. Stach – Body Weight Support Treadmill Training – a systematic review of meta-analyses. Fizjoterapia Polska 2020; 20(1); 66-77

Abstract
Aim. Although the effectiveness of Body Weight Support Treadmill Training has already been confirmed in various patients, its superiority over other physiotherapeutic interventions is unclear. The aim of this review was to compare the effectiveness of BWSTT in relation to other methods in various patients group.
Material and methods. A systematic review of meta-analyses was performed with: Cochrane Database of Systematic Reviews, MEDLINE and PEDro from the beginning until January 2019. 1775 publications were identified, of which 4 metaanalyses and one systematic review were included.
Results. BWSTT was more effective than other physiotherapeutic interventions in short-term increasing gait endurance and speed in stroke patients walking independently, and in improving functionality after hip replacement. In terms of: increasing the chance of independent walking, improving gait endurance and speed in dependent stroke patients; increasing walking distance and speed after a spinal cord injury and increasing the walking speed and cadence and stride length in Parkinson’s disease BWSTT was not more effective than standard physiotherapy.
Conclusion. The use of BWSTT may be beneficial for stroke patients who walk independently and at people after hip replacement. In the other areas, insufficient evidences were found.

Key words:
Body Weight Support Treadmill Training, gait, body weight support, systematic review, meta-analysis

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Wpływ odciążenia masy ciała poprzez system Parestand na kinematykę chodu – badanie pilotażowe

Beata Stach, Marcin Błaszcz

B. Stach, M. Błaszcz – Influence of body weight support via Parestand system on gait kinematic — a pilot study; Fizjoterapia Polska 2018; 18(1); 84-94

Abstract

Background. Many studies have recently confirmed the effectiveness of the Body Weight Support (BWS) Treadmill Training in healthy subjects and various clinical conditions. It is rarely practised method in Poland. No study about influence of Polish Parestand system on kinematic parameters of gait have been reported to date.
Material and Methods. The kinematics of the right lower limb of a healthy woman was analysed, while walking on the treadmill without support (0%) and with 25% and 50% BWS via the body weight support system Parestand at velocity of 3; 4 and 5 km/h in the initial contact (IC), loading response (LR), terminal stance (TSt) and mid swing (MSw) phase. The joint angle parameters were collected using the Noraxon system and then subjected to statistical analysis.
Results. BWS via Parestand (25% and 50%) significantly changed hip kinematics at each velocity. Knee kinematics significantly differed at 25% BWS in IC and LR, and at 50% BWS in IC, LR, TSt and MSw at each velocity. Ankle angular values did not differ significantly at 25% BWS at any velocity, and at 50% BWS were significantly different only at 3 km/h in all tested phases.
Conclusions. Increasing of BWS changes gait kinematic in a bigger extent. Even a 25% of body weight support via Parestand could change hip kinematics during gait. 25% BWS via Parestand could change knee kinematic in the early gait phases without modifying the ankle kinematics. A study in this area should be carried out on a larger number of subjects.

Key words:

gait, body weight support, Gait Kinematic, Body Weight Supported Treadmill Training

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Body Weight Supported Treadmill Training with Parestand system as walking therapy of patients early after stroke: a pilot study

Beata Stach, Marcin Błaszcz, Aleksandra Bober, Mariola E. Wodzińska, Joanna Zyznawska

B. Stach, M. Błaszcz, A. Bober, M. E. Wodzińska, J. Zyznawska – Body Weight Supported Treadmill Training with Parestand system as walking therapy of patients early after stroke: a pilot study. FP 2016;16(2);54-63

Abstract

Background. Body Weight Supported Treadmill Training (BWSTT) is high intensive and task-specific gait therapy for stroke patients. Effectiveness of BWSTT is repeatedly proven, however superiority of that training over overground walking is often contested. It is rarely practised and investigated method in Poland.
Patients and Methods. 20 patients in the early post-stroke rehabilitation phase able to walk. All patient participated in traditional physiotherapy based on Bobath and PNF concepts. Experimental group (10 people) additionally received Body Weight Supported Treadmill Training. Control group (10 people) additionally received overground walking. Baseline and postintervention assessments included Berg Balance Scale, Timed Up & Go, 10 m Time Walking Test and 6 Minute Walk Test.
Results. Both groups showed statistically significant improvement in all outcome measures (P<0,05). Group BWSTT increased distance by 108,4±75,7 m and control grouop by 57±51,3 m in 6 Minute Walk Test. Difference between the groups was not statistically significant (p=0,28). Group BWSTT shortened time in Timed Up & Go by 9±1,4 seconds and control group by 2,7±1,1 seconds. Difference between the groups was not statistically significant (p=0,63). Group BWSTT improved by 7,0±3,7 points, and control group by 6,6±4,4 points in Berg Balance Scale. Difference between the groups was not statistically significant (p=0,88). Group BWSTT increased gait velocity by 0,25±0,13 m/s, and control group by 0,28±0,13 m/s. Difference between the groups was not statistically significant (p=0,96).
Conclusions. Either Body Weight Supported Treadmill Training or overground walking could improve balance, reduce risk of falls, increase endurance and velocity of gait in walking subacute stroke patients. BWSTT could have tendency to more effective increasing gait endurance.

Key words:
stroke, hemiparesis, physiotherapy, rehabilitation, gait

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