Background: The use of body weight support (BWS) has been commonly used in gait rehabilitation of individuals with gait impairment in conjunction with treadmill. For gait, those
systems reduce the load that should be overcome by the subject during walking, promoting symmetry between paretic and nonparetic limbs on the body weight distribution and step length as the erect
posture is maintained, which seen to be the requirements for a good gait performance. Usually, steady-state gait is evaluated when a gait training protocol using BWS is employed. However, one aspect
that would be interesting to investigate is the transition between a standing still position and the execution of the first step, know as the gait initiation (GI). In this way, we raised two
questions: would subjects with gait impairment improve their performance on gait initiation after a gait training protocol with BWS? Would the walking surface that BWS is employed influence the
possible improvement? Although the target population in this study was stroke survivors, who usually present gait impairment, the results of this study could be useful for any population that present
gait impairment or injury that may compromise locomotion. In this way, the purpose of this study was to investigate the effects of gait training with BWS on a treadmill and over the ground on the
performance of gait initiation of stroke survivors.
Methods:Fifteen individuals with chronic stroke (> 6 months) were randomly assigned to two gait training with BWS groups: treadmill group (TMG, n=8) or overground group (OGG, n=9).
Both groups underwent gait training three times/week for 6 weeks. During the training session, TMG walked continually on a treadmill as the OGG walked on both directions (back and forth) along a 7m
walkway. GI was assessed before and after the 6 weeks period. All individuals were instructed to initiate gait with the paretic limb from a quite stance position with one foot on each force plate,
side-by-side at a comfortable and self-selected speed. Passive reflective markers were placed on main anatomical landmarks of lower limbs for subsequent calculation of kinematic variables. Step length
of paretic limb and displacement of center of pressure (CP) in the medial-lateral (ML) and anterior-posterior (AP) directions were calculated.
Results: Overall, gait training with BWS promoted increase on step length regardless the surface which BWS was employed. On the other hand, only the OGG improved CP displacement in
the ML direction during the postural phase.
Conclusions: The results of this study revealed that gait training with BWS improve the performance of gait initiation of individuals with gait impairment. Besides that, additional
benefits can be reached in this task when the training is conducted over the ground, improving lateral stability that can reduce fall risks. Taking together, those findings can encourage the use of
BWS to implement gait training of different populations and setting such as athletics rehabilitation.