Body Weight–Supported Treadmill Training in the Acute Care Setting

Abstract

Purpose: While previous studies have investigated the use of body weight–supported treadmill training (BWSTT) at various stages post-stroke, a greater focus has been on subacute and chronic stroke populations and less on how this training intervention could be implemented in the acute stages post-stroke. The purpose of our study is to demonstrate the safety and feasibility of implementing BWSTT in the very early acute phase following ischemic stroke. Methods: One-hundred and two subjects participated in BWSTT in addition to conventional therapy sessions while in the acute care hospital. Training was initiated, on average, 3.15 days from diagnosis to the initial treadmill session. Outcome measures included heart rate, blood pressure, Mobility Scale for Acute Stroke, Trunk Control Test, gait speed, and the SF-12v2. Results: Three hundred and six sessions were completed with 102 participants. Of the sessions completed, 13 were stopped due to blood pressure measurements above set parameters and did not return to within parameters during provided rest breaks. One thousand one hundred and nineteen systolic blood pressures (SBPs) were obtained during the study. Twenty-eight SBPs fell below 100, with 2 of the 28 resulting in an adverse event. Three total adverse events occurred out of 306 individual sessions, including 2 vasovagal events and an age-indeterminate peroneal tendon tear. The adverse events noted were transient and without harmful effects, and patients could complete future BWSTT sessions. Therefore, we consider 3 stopped sessions out of 306, 0.98%, as an acceptable rate of adverse events for future studies in BWSTT in patients with very early poststroke. Conclusions: BWSTT is a safe and feasible intervention to assist with higher-level physical activity in the acute stroke population during the early recovery stages.