Exercise 15: Walking with Resistance in the Solo-Step

Setup: Fit the patient into the Solo-Step harness and connect the lanyard to the trolley on the overhead track. Attach one end of the resistance band securely to the back of the harness and have the therapist hold the opposite end of the band with both hands. Select a resistance level appropriate for the patient’s current strength and rehabilitation stage. The therapist should position themselves directly behind the patient at a distance that creates a noticeable but manageable backward pulling force before the patient begins walking. Adjust the lanyard length to allow natural upright walking while ensuring the system can engage immediately if balance is lost.

Starting Position: Have the patient stand tall at one end of the track with feet hip-width apart, core lightly engaged, and arms relaxed at their sides or bent naturally for walking. Instruct the patient to feel the tension of the band at their back and take a moment to establish their balance before initiating movement. The therapist should be positioned directly behind the patient, holding the band with both hands and prepared to walk in unison.

The Exercise:

1. Cue the patient to begin walking forward along the track while the therapist follows directly behind, maintaining consistent band tension throughout the walk.
2. Instruct the patient to maintain an upright trunk and drive through each step with purpose, resisting the backward pull by engaging the hip extensors, glutes, and core throughout every stride.
3. Encourage the patient to maintain a normal heel-to-toe gait pattern and a natural arm swing, rather than leaning forward excessively to compensate for the resistance.
4. The therapist should walk at the same pace as the patient, keeping the band taut and the resistance consistent. The therapist can increase or decrease tension in real time by adjusting the distance between themselves and the patient as needed.
5. Continue walking forward along the full length of the track for the prescribed distance or duration.
6. Have the patient pause, reestablish their balance, and walk back toward the starting position with the therapist following and maintaining light band tension on the return.
7. Repeat for the prescribed number of repetitions, sets, or duration.

Progressions: As strength and confidence improve, the therapist can advance the exercise by increasing the resistance level of the band, increasing the distance walked against the resistance, adding high knees or an exaggerated step pattern during resisted walking, incorporating a dual task such as catching and throwing a ball while walking, or combining the resistance walking with a speed challenge to further elevate the cardiovascular and neuromuscular demands of the exercise.