Many of the 700,000-plus people who experience a stroke each year never regain the ability to walk like they did prior to the stroke, but PTs, using a specialized treadmill, have found a new way to help stroke patients walk again.

The approach, known as locomotor treadmill training with partial body weight support, consists of a treadmill outfitted with a harness. Patients are secured to a harness to support a portion of their body weight while walking on the treadmill. In the reduced-weight environment, patients relearn how to walk in a safe and controlled manner. When patients become stronger, more body weight is added until they can comfortably walk on their own without the need for assistance.

The results of a study conducted at Baylor Institute for Rehabilitation (BIR) that examines this process appear in the April 2008 issue of the Archives of Physical Medicine and Rehabilitation.

During rehabilitation, stroke patients often develop an abnormal gait pattern, which can be difficult and sometimes impossible to correct.

“Gait impairment is common after a stroke with many survivors living with a walking-related disability, despite extensive rehabilitation,” says Karen McCain, DPT, lead investigator of the study at BIR. “Walking incorrectly not only creates a stigma for these patients, but it also makes them more susceptible to injury and directly affects their quality of life.”

After completing the pilot study, all seven of the enrolled patients were able to walk with a basically normal gait pattern and without the use of a cane.

“In my 14 years as a physical therapist I have not treated seven stroke patients total that walk this well,” she said. “We are definitely onto something.”

Lisa Day, a 44-year-old with no family history of stroke, was completely paralyzed on
her left side after experiencing a stroke in September 2007. Within 3 weeks of sessions on the treadmill she was walking again the way she did prior to her stroke.

“I brought a wheelchair home from the hospital in case I needed it, but I only used it twice,” Day said. “To see me walk, you would never know that I had a stroke.”

Lisa has resumed sessions on the treadmill—this time for exercise—and walks more than a mile several times a week.

“The key to the success of our method is early intervention. All of the patients started on the treadmill as soon as possible during the acute period of recovery after their stroke,” McCain said. “We wanted to keep these abnormal gait patterns from developing in the first place.”

There is no consensus regarding the optimal treatment for reestablishing a normal gait pattern in stroke patients. Most are rehabilitated using walkers and other assistive devices.

“Our ultimate goal for this study is to one day change the clinical practice in physical therapy,” McCain added.

Baylor Institute for Rehabilitation is a not-for-profit, 92-bed hospital that offers intense, specialized rehabilitation services for traumatic brain injuries, spinal cord injuries, strokes, and other orthopaedic and neurological disorders. Physicians specializing in physical medicine and rehabilitation, known as physiatrists, lead interdisciplinary clinical teams, which work with patients to design and implement a treatment program to achieve the patient’s goals. In 2007, the facility was named among the top rehabilitation hospitals in US News & World Report’s America’s Best Hospitals guide, an honor it has received for 10 years.