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Locomotor Training

Brain 7 A53 Front Harness 2Locomotor Training is a rehabilitation strategy that allows individuals with certain kinds of spinal cord injuries to repetitively practice standing and stepping using body weight support and a treadmill with manual facilitation from therapists and technicians. The ultimate goal is to re-train patients with spinal cord injuries to stand and walk again.

In a Locomotor Training session, the individuals body is suspended in a harness over a treadmill while specially trained therapists and technicians move his/her legs to simulate walking.

In addition to improving mobility in certain patients, Locomotor Training has been shown to enhance the overall health of patients. Potential benefits include improving cardiovascular and pulmonary functioning, promoting the strength and healing potential of skin, increasing blood flow to the upper and lower extremities, increasing bone density, and improving bowel and bladder functioning. Improvements in emotional and psychological well-being have also been noted.

Locomotor Training Components

  • Step Training utilizes body weight support and the treadmill system in combination with manual assistance provided by specially trained physical therapists to promote walking at a normal walking speed. Training principles are utilized in this component to help the nervous system relearn motor patterns associated with walking.
  • Overground Training takes the nervous system’s new capacity to the overground environment. In this setting, specific limitations to independent walking including gait deviations are addressed.
  • Community Integration implements principles that will help patients meet the overall goal of the program: safe and effective ambulation in the home and community.

Supporting Research

Locomotor Training: Principles and Practice 1st Edition.
Susan Harkema, PhD, Andrea Behrman, PhD, PT, and Hugues Barbeau, PhD.

Roy RR, Harkema SJ, Edgerton VR. Basic concepts of activity-based interventions for improved recovery of  motor function after spinal cord injury.<> Arch Phys Med Rehabil. 2012 Sep;93(9):1487-97. doi: 10.1016/j.apmr.2012.04.034.

Behrman AL, Lawless-Dixon AR, Davis SB, Bowden MG, Nair P, Phadke C, Hannold EM, Plummer P, Harkema SJ. Locomotor training progression and outcomes after incomplete spinal cord injury. Phys Ther. 2005 Dec;85(12):1356-71

Behrman AL, Bowden MG, Nair PM. Neuroplasticity after spinal cord injury and training: an emerging paradigm shift in rehabilitation and walking recovery. Phys Ther. 2006 Oct;86(10):1406-25. Review.

Harkema SJ, Schmidt-Read M, Lorenz DJ, Edgerton VR, Behrman AL. Balance and ambulation improvements in individuals with chronic incomplete spinal cord injury using locomotor training-based rehabilitation. Arch Phys Med Rehabil. 2012 Sep;93(9):1508-17. doi: 10.1016/j.apmr.2011.01.024. Epub 2011 Jul 20.

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