2011 APTEI Acupuncture & Dry Needling (ADN) Program

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June is Brain Injury Awareness Month Clinical use of Bodyweight Supported Treadmill Training for Clients with Acquired Brain Injury By Jaime MacDonald MSc PT , Physio-Logic/Neurological Rehabilitation Physiotherapists have been using bodyweight supported treadmill training (BWSTT) as a component of neurological rehabilitation for a number of years. The theory of generating a reciprocal gait pattern from the level of the spinal cord originated with the study of de-corticated cats showing that a rhythmical stepping pattern can be elicited through peripheral stimulation of neuronal networks within the spinal cord, now termed ‘Central Pattern Generators’. This neurophysiological research evolved into the development of BWSTT being utilized in the treatment of many neurological populations to improve overground walking, increasing gait velocity and stride length in individuals who have sustained an incomplete spinal cord injury, a stroke, or Parkinson’s disease. Currently there is very little research investigating or supporting the use of BWSTT as a treatment intervention with clients who have acquired brain injuries. Considering many of these people have adjunctive cognitive, or behavioral impairments, they are often less appropriate for standardization into a clinical trial. Bilateral hypertonicity and lower extremity contractures are prevalent in the population, and often interfere with the standard protocol of a treadmill program which can PHYSIOTHERAPIST REQUIRED For Toronto, Kitchener Waterloo and Niagara Area Please submit your resume to 416-226-9581 Or for more information contact: Reshawn 416-226-2402 Reshawn_ninth.indd 1 27/06/11 3:14 PM more easily be applied to individuals who have sustained a stroke or spinal cord injury. While current literature is very limited in the evaluation of BWSTT as an effective intervention in the treatment of people with acquired brain injuries, clinically the benefits are similar to that of other neurological populations. The treadmill harness and ability to de-weight provides the client with a safe environment to begin standing and weight bearing. This weight bearing position provides sensory stimulation from the feet and lower limbs, and assists in the treatment of lower extremity contractures. The harness frees up the therapist’s hands to facilitate alignment, rather than supporting the weight of the client. The improved alignment and upright posture will encourage the development of an appropriate body schema in the cortex which facilitates core and lower extremity muscle activation. As the client progresses, the harness and de-weighteing system allows the therapist to facilitate the client into more advanced pre-gait postures such as single leg stance. While the initial postural stability is gained from the harness, treatment is aimed to gradually decrease the supports as the client begins to regain postural control on which they Antibex_ad:Layout can move the extremities 1 7/2/08 into 3:28 func- PM Pag tional positions including initial weight ANTIBEX SOFTWARE Great Ideas at Work! ✔ Scheduling ✔ Claim Forms (MVA, WSIB, EHC) ✔ Billing (MVA, WSIB, EHC, Private, Slip & Fall) ✔ HCAI Compliant Get it FREE Today! ✔ Reminders and Alerts ✔ Electronic SOAP Notes ✔ Multiple Computers ✔ Multiple Providers www.antibex.com 416-663-3777 Experience the benefits for yourself! 22 Jamie working on the treadmill with a client who has a brain injury. transfer and stepping. These first stages of intervention are controlled purely through cortical control, and therefore there is no activation of the central pattern generator networks. According to recent literature cortical control of ambulation decreases once a consistent speed of 2.5km/hour is reached, and it is hypothesized that the lower spinal centres generate the walking pattern at higher speeds. This high velocity subcortical gait provides ascending cortical feedback that is then used to modulate current and future descending gait control. It is this cyclic feedback and feed forward locomotive control that the client ultimately benefits from, and relates to the improved functional outcomes in overground walking. While research and clinical trials have not widely investigated or supported BWSTT for use with clients who have acquired brain injuries, clinically, the improvements have been similar to that of other populations including increased overground stride length and velocity, increased balance, and increased functional independence.
CALA Wellness Conference 1-888-751-9823 hosted by the City of Mississauga September 9, 10, <strong>2011</strong> Clarkson Community Centre Release, Realign Re-educate, Rebuild - A Water and Land Based Approach to Healing and Prevention of Illness and Injury CALA CanFitPro AFLCA BCRPA NSFLA Accredited by CPTN PTA OTA OKA LSS www.calainc.org SPRA SportPEI NLPRA YMCA YWCA
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2011 APTEI Acupuncture & Dry Needling (ADN) Program

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