EQUIPMENT FOR LB THERAPY

The treadmill (German: Laufband, Tretmühle)

Since a treadmill, Tretmühle was a device for very hard (slave) work to grind corn or move heavy loads we have been using the term Laufband or Laufband therapy instead. Laufband means "moving band" and describes the equipment we actually use in our therapy much closer: A motor driven moving band with a special frame and a suspension system.

There have been different versions of treadmills on the market, none of which, however, could be used as they were when we started in 1989. The only other group then working on the therapy (Barbeau in Montreal) built the necessary equipment themselves, we asked WOODWAY GmbH, Germany to adapt their equipment according to our needs. Meanwhile a few suitable apparatus are commercially available. Here are the necessary requirements:
Speed range: 0.1 to 5.0 km/h, steps of increment: 0.1 km/h.

Motor needs to produce enough power to allow an even progression of the band also against resistance. Band speed must not become significantly reduced by loading.( Check yourself by trying to stop the band).

To the sides of the moving band, a broad board equipped with seats for the therapists is absolutely necessary. The therapists not only have to sit comfortably but sometimes also need to lean with their back against one of the poles of the frame to balance themselves when moving very spastic legs. For that purpose, therapists also put one of their legs onto the board. Obviously, the surface of the band and this board need to be sufficiently elevated from the ground to allow (relatively) comfortable sitting (some 35 cm). For handling of less spastic patients some therapists find it comfortable to work in standing; for this purpose the whole treadmill may be put onto a stage with adjustable height. For such setting width of the moving band should not be broader than some 55 cm so a single therapist can reach both legs. An elevated surface, however, may cause fear and additional confusion in patients with deficits in perception.

Somewhat surprizingly, there are very expensive models of treadmills on the market, which don't allow the therapist to sit at the side and the surface of the moving belt is close to the ground. Obviously with such equipment, little help can be given by therapists with limb setting, consequently only patients already ambulating may be properly trained with such models (s.Nilsson et al 2001).