Critically Appraised Topic
The patient who led me to pursue this question is a 52-year-old male, approximately 28 months post-incomplete spinal cord injury (iSCI) at T11. Medical treatment to date has included over-ground gait training, strength training, and functional activities. Physical therapy diagnoses include gait abnormality and general weakness.
Is body-weight support treadmill training an effective intervention for increasing gait speed for patients with incomplete spinal cord injury?
Clinical Bottom Line
Based on the results from Dobkin et al. and Hicks et al., BWSTT has the potential to increase walking speed in patients with both acute or chronic iSCI and classified as ASIA C or D. According to Dobkin et al., patients with acute iSCI (<8 weeks post-iSCI) can benefit equally from BWSTT or over-ground gait training 5x/week for 12 weeks to improve and maintain walking speed for up to 3-months. According to Hicks et al., patients with chronic iSCI (≥12 months post-iSCI) can improve and maintain walking speed for up to 8-months after BWSTT 3x/week for 144 sessions. Since these given treatment frequencies and durations are likely unreasonable for an average person and BWSTT systems are expensive, it may be best to utilize BWSTT (if it is readily available for use) until the patient is able to walk over-ground. Once over-ground gait training is possible, this can be practiced and maintained as a home program and challenged and progressed at therapy.
Tagami, Erin, "The Effect of Body-Weight Support Treadmill Training on Gait Speed for Patients with Incomplete Spinal Cord Injury" (2010). PT Critically Appraised Topics. 23.