Study evaluates novel body weight–supported postural perturbation module for gait, balance rehabilitation after stroke

The study, “A Novel Body Weight–Supported Postural Perturbation Module for Gait and Balance Rehabilitation After Stroke: Preliminary Evaluation Study,” demonstrates that balance perturbations in a recently developed and not-yet-reported balance perturbation program for the Aretech LLC ZeroG body weight support system positively impacted the balance performance of a subset of stroke inpatients at Gaylord Hospital, a long-term acute care hospital in Wallingford, Connecticut. The program, known as Training Responses in Postural rehabilitation, or TRiP, helped to improve participants’ overall confidence and reduce their fear of falling.

Primary investigator, Amanda Meyer MS OTR/L, Gaylord Hospital inpatient occupational therapist, explained, “Because of the novelty of the TRiP program, the study had three goals: to evaluate the safety and feasibility of using the technology in the clinical setting, to develop a practical protocol for clinical use, and determine if there is evidence to suggest that the perturbation system conveys additional benefit to gait and balance rehabilitation after stroke.”

The use of body weight support systems following a stroke, spinal cord injury, or other neurological disorders has expanded over the last two decades. These systems support patients’ body weight, permitting those with excessive weakness and poor coordination to safely walk and perform more intensive therapy sessions sooner in their recovery while protecting them from injurious falls.

In addition to body weight support systems, balance perturbation systems improve gait and balance control after stroke or in response to other age and disease-related balance impairments. This is accomplished by purposefully unbalancing patients so they can rehabilitate their postural control.

Compared to past devices that use a tilt table or modified treadmill, the ZeroG TRiP balance perturbation training module is directly integrated into the system allowing therapists to induce safe lateral, anterior, and posterior perturbations via a Wi-Fi–enabled handheld device.

To be considered for the study, inpatient stroke rehabilitation patients had to score 21 or greater on the Berg Balance Scale, be 18 years or older, and be able to tolerate and participate in at least three 30-minute weekly sessions in the ZeroG.

Of the 29 participants who completed the treatment course, 15 were assigned to the control group and 14 to the perturbation group.

During both stationary and ambulatory activities, the system was used to unbalance participants in the perturbation group to train their balance control.

In addition to developing a practical protocol for clinical use and confirming the safety of the ZeroG TRiP system, both groups showed similar improvements in balance, balance confidence, and walking, indicating that the protocol is not detrimental and may benefit post-acute stroke balance deficits.

“While the research is promising, it warrants further investigation to reach a definitive conclusion about the efficacy of the ZeroG TRiP system. As the prevalence of these systems continues to grow, there will be a number of opportunities for further research and development in this area,” said Meyer.