Dynamic Overground Body Weight-Supported Gait Rehabilitation in a Mechanically Ventilated Patient

Objective: Sufficient patient mobilization can be difficult to achieve with mechanical ventilation during a patient’s hospital stay. This case report describes the novel use of overground dynamic body weight-supported (DBWS) gait and balance training in a mechanically ventilated patient. Feasibility and safety of the device are demonstrated for this case, and the patient’s recovery trajectory and outcomes are described. Methods (Case Description): A 68-year-old female admitted to inpatient rehabilitation following a prolonged hospital stay received dynamic body weight-supported gait and balance training while mechanically ventilated. DBWS gait and balance training session parameters were tracked and functional outcomes assessed at regular intervals. Results: DBWS gait training was well-tolerated; the patient demonstrated immediate carryover to overground ambulation and improved endurance following several sessions. Patient progression warranted changes to the type and duration of DBWS training activities across sessions, all of which were well-accommodated by the DBWS system. Conclusion: Dynamic body weight support-based training was a safe, effective means of engaging this mechanically ventilated patient in overground gait training during her inpatient rehabilitation stay. Specific guidelines and precautions can ensure that each patient is a good match for this modality before initiating therapy sessions. In addition, patients should be continuously reassessed, and adjustments made as therapy progresses. Impact: To our knowledge, this case report is the first to describe the use of overground DBWS gait training in a mechanically ventilated patient, with demonstrated feasibility, safety, and functional outcome improvement. It also provides clinical guidance for patient selection and overground gait training therapy sessions.