Practical issues in retraining walking in severely disabled patients using treadmill and harness support systems

In the last decade, a novel form of gait training using a treadmill and partial body weight support through an overhead harness has been described for patients with neurological impairments caused by stroke and spinal cord injury (for review see Barbeau et al 1998). The overhead harness attached over a treadmill decreases postural demands and supports part of the body weight, which allows the individual to walk without collapse of the affected lower limb or limbs. One of the barriers to completion of walking practice by severely disabled patients is that marked muscle weakness and poor co–ordination results in an inability to practice the whole task without considerable assistance. Patients often require the assistance of two or more people to stand and take a few steps. The benefit of treadmill walking with body weight support via an overhead harness for these patients is that it provides the opportunity to complete larger amounts of practice of the whole task, early after neurological impairment.