Dynamic Body Weight

Support and Rehabilitation

Sophie Grossnickle
Body Weight Support (BWS) Systems
Static Body Weight Support Systems Dynamic Body Weight Support Systems
• Unweighting system that offloads a set • Unweighting system that is responsive dynamic force
percentage of an individual’s bodyweight changes, ensuring consistent offloading
measured at rest • Pros:
• Pros: • Provides more consistent unloading during movements
• Increases patient safety • Increases patient safety
• Can reduce patient’s fear of falling • Reduces patient’s fear of falling
• Allows for increased intensity and repetition • Allows for increased intensity and repetition
• Cons: • Allows for more normalized sensory feedback
• Does NOT account for the dynamic forces, so compared to static BWS
unweighting is not consistent • Cons:
• Harnesses utilized often limits pelvic motion, hip • Limited research utilizing standard dosage to
ROM, and shortens stride length determine effectiveness of Dynamic BWS training in
• Studies have found static BWS causes non- IPR/IRF
physiologic ground reaction forces, resulting in • $$$ of equipment
less functional LE muscle activation • Large equipment
Body Weight Support Systems
How do BWS systems work?
• Static BWS
• Unloads a set weight
• Dynamic BWS
• Unloads set weight at rest
• With vertical and horizontal
forces:
• Force sensor: identifies the
amount of offloading force at
any given time
• Controller: creates a feedback
loop between the force sensor
and the actuator
• Actuator: controls tension on
the rope
BWS Systems at Mary Free Bed
• ZeroG (Aretech, LLC, Ashburn, VA)
• Overhead dynamic BWS harness system
• Dynamic BWS from 10-200 lbs
• Static BWS up to 450 lbs
• Features
• Free Walk
• No resistance, allows for overground gait training
• Resistance
• Anterior/posterior drag, can utilize to improve trunk stability/strength and balance
• Facilitation
• Harness system is positioned anterior to patient to increase speed of ambulation
• Training Responses in Postural Rehabilitation (TRiP) Perturbations
• Perturbations facilitated by the harness system to train postural responses, to improve balance and fall responses
• Fall Protection
• Set distance
• Velocity dependent
• Disabled (will still limit rate of descent)
ZeroG BWS System
ZeroG BWS System
BWS Systems at Mary Free Bed
• Ovation (Aretech, LLC, Ashburn, VA)
• Dynamic BWS system + rubberized slat treadmill
• Launchpad: up to 1000 lbs
• Winch capacity: up to 700 lbs
• Dynamic BWS: 25-300 lbs
• Static BSW: up to 700 lbs
• Features:
• Fall protection
• Automatic stop
• Winch system
• Can assist with standing
• Therapist seating
• ”Infotainment”
• Virtual screen with options to view set videos of walks, photos, and cognitive tasks.
• Also displays metrics (calories, distance, goals, etc.)
Ovation BWS System
Ovation BWS System
 Evidence Based Practice
• Methods •Results
• Retrospective chart review • Both groups demonstrated a significant increase
in FIM scores
• Functional Independence Measure (FIM) • Dynamic BWS had significantly larger magnitude
scores of score increase compared to SOC
• Participants • Dynamic BWS had a significantly greater
increase in sphincter control compared to SOC
• n=52 •Limitations
• Dynamic BWS: n=26 • Lack of standard training protocol
• Standard of Care (SOC): n=26 • Lack of standard dosage
• Small sample size
• Inclusion criteria:
• First acute ischemic stroke with motor
impairments requiring IPR stay, used
dynamic BWS system at least 2x during
episode of care
• Exclusion criteria:
• >1 stroke, hemorrhagic stroke, length of
stay <10 or >35 days, or did not
complete 3 hours of therapy 5
days/week
Evidence Based Practice
• Methods •Results
• Retrospective cohort chart review • No significant difference in improvement of total FIM
scores
• FIM scores • Dynamic BWS overground training significantly greater
• Participants improvement of sphincter control
•Limitations
• n=22 • Lack of standard protocol
• n=11 historical records • Small sample size
• n=11 Dynamic BWS overground training • Groups not completely weight matched (historical records
statistically weighed > dynamic BWS group)
• Inclusion criteria:
• History of non-traumatic spinal cord injury,
3 hours of therapy 5 days/week, and
Dynamic BWS training 3x during episode of
care
• Exclusion criteria:
• Unstable cardiopulmonary conditions, LE
contractures, uncontrolled diabetes, severe
osteoporosis, severe spasticity, skin lesions
that interfere with the dynamic BWS
system, and/or severe syncopal symptoms
References
• Kim J, Oh S, Jo Y, Moon JH, Kim J. A robotic treadmill system to mimic overground walking
training with body weight support. Front Neurorobot. 2023;17:1089377. Published 2023 Jun 9.
doi:10.3389/fnbot.2023.1089377
• MacLean MK, Ferris DP. Design and Validation of a Low-Cost Bodyweight Support System for
Overground Walking. J Med Device. 2020;14(4):045001. doi:10.1115/1.4047996
• Huber J, Elwert N, Powell ES, Westgate PM, Hines E, Sawaki L. Effects of dynamic body weight
support on functional independence measures in acute ischemic stroke: a retrospective cohort
study. J Neuroeng Rehabil. 2023;20(1):6. Published 2023 Jan 16. doi:10.1186/s12984-023-01132-9
• Huber JP, Sawaki L. Dynamic body-weight support to boost rehabilitation outcomes in patients with
non-traumatic spinal cord injury: an observational study. J Neuroeng Rehabil. 2020;17(1):157.
Published 2020 Nov 30. doi:10.1186/s12984-020-00791-2
• Houssein L. Contribution to the development of an experimental device based on a robotic
platform for gait rehabilitation. Biomechanics [physics.med-ph]. Ecole Nationale d’Ingénieurs de
Monastir (Tunisie), 2016.English. NNT: . tel-02496096