Episode 49 – Body Weight-Supported Treadmill Training – Scorebuilders

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Episode 49 – Body Weight-Supported Treadmill Training

Scott Giles PT, DPT, MBA
Posted 03/04/2025

Watch the video version of this episode on YouTube - https://youtu.be/9rvdmQgd1DA

A physical therapist uses body weight-supported treadmill training to help a patient improve their gait pattern following a stroke. Initially, the therapist selects the following parameters: body weight assistance of 40%, treadmill speed of 1.0 mph, treadmill incline of 0%. 

As the patient sees improvement with training, which of the following parameters should the therapist use?

1. Assistance of 50%, speed of 1.5 mph, incline of 0%
2. Assistance of 50%, speed of 1.0 mph, incline of 10%
3. Assistance of 30%, speed of 1.5 mph, incline of 0%
4. Assistance of 30%, speed of 1.0 mph, incline of 10%

Transcript

Welcome back to the Scorebuilders’ Question and Answer Podcast! This podcast provides members of the Scorebuilders’ team with the opportunity to explore challenging multiple-choice examination questions with students actively preparing for the licensing examination. My name is Scott Giles and I will be your host for today’s journey.

Ready? Let’s go!

A physical therapist uses body weight-supported treadmill training to help a patient improve their gait pattern following a stroke. Initially, the therapist selects the following parameters: body weight assistance of 40%, treadmill speed of 1.0 mph, treadmill incline of 0%. 

As the patient sees improvement with training, which of the following parameters should the therapist use?

1. Assistance of 50%, speed of 1.5 mph, incline of 0%
2. Assistance of 50%, speed of 1.0 mph, incline of 10%
3. Assistance of 30%, speed of 1.5 mph, incline of 0%
4. Assistance of 30%, speed of 1.0 mph, incline of 10%

Body Weight-supported Treadmill Training
Body weight-supported treadmill training is performed with the use of a harness attached to the patient’s pelvis and trunk and suspended from the ceiling or mechanical apparatus, which allows for unweighting of the body while ambulating on a treadmill. 

Use of a harness allows the patient and therapist to focus on achieving an optimal gait pattern since it reduces the fear of falling, decreases the postural stability demands of gait, eliminates the need for upper extremity support, and decreases the extent of muscle activation required by the patient.

Benefits of Body Weight-supported Treadmill Training

  • reduces the fear of falling
  • decreases the postural stability demands of gait
  • eliminates the need for upper extremity support
  • decreases the extent of muscle activation required by the patient

Let’s explore each of the options:

Option 1 - Assistance of 50%, speed of 1.5 mph, incline of 0%
The harness is used to support a portion of the patient’s body weight. The therapist typically provides 30-40% assistance to the patient when initiating treatment. The therapist should decrease, not increase, the level of assistance required as the patient improves. However, it would be appropriate to increase the speed of the treadmill as the patient improves. The grade of the treadmill is the same in this option as specified in the original parameters.

Option 2 - Assistance of 50%, speed of 1.0 mph, incline of 10%
The therapist should decrease, not increase, the level of assistance required as the patient improves. Additionally, the incline of the treadmill is not a parameter that is typically altered with body weight-supported treadmill training. It would be more important to decrease the level of assistance and increase the treadmill speed to ensure the patient can eventually transition to overground gait training.

Option 3 - Assistance of 30%, speed of 1.5 mph, incline of 0%
When using body weight-supported treadmill training, the therapist will often utilize 30-40% assistance when initiating treatment and will decrease the level of assistance as the patient improves. Likewise, the therapist will initiate treatment with slow treadmill speeds (i.e., 1.0 mph) and will gradually increase the treadmill speed as the patient improves. The grade of the treadmill is the same in this option as specified in the original parameters.

Option 4 - Assistance of 30%, speed of 1.0 mph, incline of 10%
It would be logical to decrease the level of assistance provided by the harness as the patient improves. 

However, the incline of the treadmill is not a parameter that is typically altered with body weight-supported treadmill training. It would be more important to increase the treadmill speed to prepare the patient for normal ambulation.

The correct answer is Option 3

Let’s explore the all student data:
7% of students selected Option 1, Assistance of 50%, speed of 1.5 mph, incline of 0%
3% of students selected Option 2, Assistance of 50%, speed of 1.0 mph, incline of 10%
74% of students selected Option 3, Assistance of 30%, speed of 1.5 mph, incline of 0% - the correct response
16% of students selected Option 4, Assistance of 30%, speed of 1.0 mph, incline of 10%

System Classification
This question is a Neuromuscular and Nervous Systems question which represents approximately 24% of all exam items.

Content Outline Classification
This question is an Interventions question which represents approximately 29% of all exam items.

Level Classification
This question is a Level 2 question since the question requires students to integrate numerous pieces of information or to apply knowledge in a given clinical scenario. Remediation of Level 2 questions occurs by increasing flexibility with academic content and by carefully analyzing decision making processes when answering applied examination questions.

Academic Focus Area
Looking to review related academic content? Check out pages 299 and 300 in PTEXAM: The Complete Study Guide.

Thanks for joining us on the Scorebuilders Q and A podcast! See you next week!