Tinsley S, Vazquez-Morgan M, Leonard C, Thompson A; Program in Physical Therapy, Department of Rehabilitation Sciences, Louisiana State University Health Sciences Center, Shreveport, LA. stinsl@lsuhsc.edu.

PURPOSE: To determine whether recovery of gait could be further improved in two individuals with neurological gait deficits by using body weight support gait training (BWS-GT) alone or in combination with traditional physical therapy. SUBJECTS: Participant A was a 60-year-old male suffering a CVA secondary to CADASIL (Coronary Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy). Participant B was a 63-year-old female with a primary diagnosis of leukoencephalopathy secondary to radiation and chemotherapy for lung and brain cancer. Participant A expressed difficulty ambulating on different surfaces and environments, and decreased gait speed and weight shift. Participant B expressed difficulty with falls and walking with a rolling walker. METHODS: Each participant’s gait was analyzed pre- and post-intervention utilizing the Ariel Performance Analysis System. Each participant was seen 2 to 3 times per week for a total of 4 weeks. During each treatment session the participants performed 4 bouts of ambulation, maximum duration of 10 minutes, with a 5-minute rest break between bouts. Participants began with 40% of their body weight supported decreasing to 0% by the end of the 4 weeks in 20% increments. Participants initially walked at 0.5 mph increasing to 1.0 mph by the end of the 4 weeks at 0.25 mph increments. Speed and BWS progression was determined by adequate gait technique through observation. An increase in treadmill speed occurred when the participant was able to walk 10 minutes for 3 out of 4 bouts with maintenance of a normal gait pattern. ANALYSIS: Digital images were used for computerized gait analysis of individual joint angles. Data were analyzed in graph format. Pre- and post-intervention analyses were generated for the outcomes of this study. RESULTS: Participant A had minimal improvement occur in step length and swing time with no improvement in step height. Participant B had improvements with decreased trunk flexion and increased hip extension, knee extension, dorsiflexion, step length and step height bilaterally. Participant B was also able to ambulate without the rolling walker at the end of the intervention period. CONCLUSIONS: Both participants had improvement in their gait pattern. Improvements may have occurred due to activation of spinal generator patterns as a contributor to the control mechanism of gait. This case study suggest that BWS-GT may be a successful treatment option for improving gait in patients with neurological deficits when combined with traditional physical therapy or as the sole intervention option. FUNDING SOURCE: None.

Copyright 2004 by the American Physical Therapy Association

Reprint Information
Requests for reprints should be directed to the corresponding author of the article. Students and other academic customers may receive permission to reprint copyrighted material from Physical Therapy by contacting the Copyright Clearance Center Inc, 222 Rosewood Dr, Danvers, MA 01923. Similar inquiries by all others should be made to the APTA Editorial Office, Attn: Physical Therapy.