An Overview of Treadmill Locomotor Training with Partial Body Weight Support: A Neurophysiologically Sound Approach Whose Time Has Come for Randomized Clinical Trials

Abstract

Much of the rehabilitation team's effort during inpatient and outpatient therapy for disabling neurologic diseases aims to restore the ability to walk with as little human assistance as possible. Although the use of treadmill (TM) training with partial body weight support has a strong underpinning from basic and clinical neuroscience stud ies and small clinical trials, the technique still lacks the reproducible results that make for an evidence-based practice. Therapists will have to learn how to employ body weight-supported treadmill training (BWSTT) so that they optimize the segmental sensory inputs that best facilitate spinal and supraspinal locomotor networks. Ran domized clinical trials must be undertaken using scientific expertmental designs that measure the impact of BSWTT on the lives of hemiparetic and paraparetic people. Outcomes specific to a locomotor intervention might include functional independence for walking and for mobility-related self-care and community activities, walking speed, endurance for walking distances, and the perceptions of subjects about health-related quality of life. Features of training and trial design are discussed in relation to reported basic and clinical research.