Treatment

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Weight-bearing Therapy

Weight bearing therapy is one of the fundamentals of both physiotherapy and occupational therapy rehabilitation for a patient with upper or lower limb impairments. Once a comprehensive assessment has been completed and appropriate goals set in conjunction with the patient, the specific exercises will be decided upon. Whether for the upper or lower limb, weight bearing is considered a mainstay of therapy.

Weight bearing for both the upper and lower limb, has many benefits including:

  • Sensory stimuli – including light touch, deep pressure and proprioceptive sensation
  • Assists with increasing level of awareness, especially in early standing with brain injured and stroke patients.
  • Weight bearing in sitting and standing also assists with posture correction and the perception of the midline
  • Management of spasticity
  • Repetitive UL weight bearing increases symmetry and facilitation of movement in the affected side in persons with hemiplegia. (https://www.ncbi.nlm.nih.gov/entrez)
  • Weight bearing also helps prevent bone loss – and can assist with bone healing post fracture.
  • Muscle strengthening
    • Weight bearing through the upper limbs assists with strengthening initially against gravity as the patient uses their own body weight. Once you start working non weight bearing with the UL, the weight of the arm is often too much for the weak muscles
    • Weight bearing allows for the development of proximal control at the shoulder in the upper limb, thus ensuring better reach and grasp ability for the patient. In the lower limb, weight bearing improves pelvic and trunk strength and stability for walking.
    • People who are able to walk independently should be offered treadmill training with or without body weight support or other walking-orientated interventions at a higher intensity than usual care and as an adjunct to other treatments.
    • People who cannot walk independently should be considered for electromechanical-assisted gait training including body weight support.

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