Before starting any exercise program for improved gait, check in with your physician or physical therapist. They can ensure that you are exercising properly and exercise is safe for you to do.
You may need an assistive device to help you walk immediately after your lower extremity injury or surgery. Your PT can help you choose the right one. Examples of assistive devices may include:. Your PT can make sure the device is the proper size for you. They can also make sure you are using the assistive device properly. Some people use their assistive device temporarily; others with significant impairments need to use it permanently. Your therapist can help you determine when it is time to ditch your assistive device.
If you are working on gait training in the PT clinic, you may use parallel bars to help you. The bars are extremely stable and allow you to use your arms for support while learning to walk again.
After lower extremity injury, you may need to work on regaining and maintaining normal range of motion ROM in your joints. Often after surgery, swelling may limit joint ROM. Range of motion may also be limited by tight muscles or structures that occur after a period of immobilization following injury or surgery.
Working to regain that motion may be part of your gait training exercise program. Exercises to improve lower extremity ROM may include:. Maintaining full ROM as you learn to walk again can help your joints move freely as you step and bear weight onto each leg.
Strengthening exercise may be incorporated into your gait training exercise program. If you have weakness in your hips, knees, or ankles, this may prevent your from walking safely.
Exercises for your lower extremities may include:. Exercises should be done slowly, and it is recommended that you use light resistance and high repetitions for lower extremity gait training exercises. Because walking is a low resistance, high repetition activity. Your exercises should mimic that type of motion.
One way to improve your gait is to accentuate the motions that occur in your legs while walking. One way to do that repetitively is to perform stepping exercises over obstacles or small hurdles. This forces you to flex your hips up high and bend your knees up behind you when walking. Here is how to perform obstacle gait training:.
Once obstacle stepping has become easy when stepping forward over the hurdles, you can try stepping over sideways. What do you do? To answer this is more than just one secret exercise or a one size fits all approach. We have worked for many years in the rehabilitation field 16 years now and work closely with many health therapists successfully helping people overcome all types of injury, from spinal injury and back pain to ACL reconstruction rehabilitation.
But out of all these injuries, the loss of the ability to walk would be right up there with being the hardest and trickiest to work with to find a successful solution for the client. In this article I am going to share with you some of our most successful exercises, strategies, and methods for helping people learn to walk correctly, or in some cases getting out of the wheel chair and learning to walk again! Some of you reading this may know of someone who has trouble with walking or you yourself have difficulty walking on a daily basis.
In the health industry walking is known as Gait. What is Gait? A gait cycle is a sequence of events in walking or running, beginning when one foot contacts the ground and ending when the same foot contacts the ground again. The human gait cycle is a very complicated, coordinated series of movements.
Which is one big reason why so many rehabilitation programs fail when they use simple methods to improve it! In the book Movement by Gray Cook he says, "movement patterns are destroyed by reductionism. Focusing on single muscles and areas of weakness will do little to improve the ability to walk. I am not saying it is a waste of time, just that we must move to integrated complicated patterns of movement to make any significant change.
Gray Cook says it best,. This chunk essentially resembles a mental motor program, the software that controls movement patterns. A pattern represents multiple single movements used together for a specific function. Many of the clients we currently work with, have spent a lot of time working with other methods of training that were predominately isolated training techniques, or methods using machines or equipment to assist with their lack of stability.
Just changing the strength or flexibility of a body part will not change a movement pattern unless the motor program is also changed. This is where we might use isolated exercises but with the purpose of instantly adding the movement pattern straight afterwards. To train balance you must be out of balance. And with this comes risk, however with us being there to support them and guide them we are able to enhance the movement faster than any other form of training.
It is not easy, and can take some time to do. Mentally as much as physically the clients are tested with these patterns but it is exactly what the brain needs in order to reprogram a new sequence that is more efficient. Read the article Movement Not Muscle for more detail on this. Watch the video below that shows you several exercises to improve the gait pattern. We currently have clients here who have goals of improving their walking ability after an accident or from a long-term neurological condition and throughout this article I will use REAL LIFE examples of what we have come across that works well and how YOU can improve your gait.
With neurological impairments like stroke, TBI traumatic brain injury , MS multiple sclerosis and cerebral palsy the damage is done within the central nervous system. We are here to fix the meter box to help out the rest of the system. In order to improve this we need to put the body under a challenge in order to switch on more nerves. We cannot ignore the role of the feet with this and this is the logical place to begin.
For any movement you do standing up, neural signalling begins at the feet as they are the first part of the body to feel the ground and tell the system what to do. They tell the brain where you are, if you are balanced enough to move yet and basically instigate movement before it even begins. The better the feet and ankles are functioning, the better the signal all they way up the kinetic chain.
Our feet and ankles are meant to withstand incredibly high forces and should provide more in terms of shock absorption than perhaps any other body part. Unfortunately, we begin to gradually lose this ability once we start wearing shoes. Over time, the feet, ankles, and toes become inhibited. And as we expose our feet to some trendy shoes with all types of padding and support, this only make matters worse and exacerbates the lazy and weak feet muscles..
Besides minimizing the ability to withstand intense ground reactive forces, the body gradually begins sending fewer and fewer signals to the feet, leading to distortions in pro-prioception and loss of innervation all the way up the kinetic chain. This is where injuries are born! Ultimately, this creates foot and ankle dysfunction that leads to inefficient movement in the body that over time leads to chronic pain.
Shortly I will explain a great way to overcome this problem but for now I suggest to watch the 2 videos below for more detail on just how important the feet are for providing stability when we move, and some simple exercises you can use to improve this. Now that we have defined the gait pattern for you and explained how important foot stability is it is time to look at some of the best exercises for improving your ability to walk. Just remember there is no one magical exercise on its own that will "fix you".
You have to use a combination of all these ideas and apply what works best for you. And you also need to be very patient as you will make many mistakes and become easily frustrated. While it may seem you are getting nowhere as you continually mess things up, keep at it, for the mistakes are exactly what the brain needs to see in order to make some adjustments.
Make sure you keep things safe and you may need someone to assist you in the early stages to overcome the fear that some of these movements create. Watch the video above to see how to complete this exercise. I also use this a test with older adults to predict a fall as you can see in the video to the right with an older adult performing it. A brain injury, stroke or a neurological disorder. And you have lost your ability to stand and walk. Now, if you are such a person or know of someone struggling to walk, then gait exercises can help.
They are exercises designed to help a person learn to walk, either as a child or after an injury or disability. They are a blend of skill-strengthening exercises that help patients to regain independence in walking even if they still need adaptive devices. Your gait is your manner of walking and gait exercises are prescribed to improve your ability to walk. The goals of gait training include increased muscle strength, better coordination in lower limbs, improved voluntary response in lower limb muscle groups, and enhanced flexibility, cardiovascular fitness, weight-bearing and balance.
For you to walk, you must always have an adequate range of joint mobility, which can enable your joints to move your muscles through a sufficient range of motion. The training also ensure unimpaired and improved input from the multiple sensory systems in your body, including somatosensory, visual and vestibular systems. Actually, gait rehabilitation is not simply a re-education on how to walk, but also involves assessment of your gait cycle, creation of an effective plan to address the problem, as well as teaching you how to walk on different surfaces.
Tailored gait exercises help to develop or maintain a functional walking pattern. For instance, in the elderly, performing gait exercises improve walking patterns within 12 weeks.
In fact, even frail elderly patients who perform the exercises for 40 minutes, times a week, show greater dynamic balance and better gait functioning compared to those who do not engage in the training. The exercises also improve endurance, muscular health and posture, all of which prevent several of the common obstacles to regaining independence. Neurologically, long-term repetitive gait training helps to strengthen nerves damaged during stroke, decreasing spasticity and weakness in crucial areas of the body.
The exercises help to improve a lot of gait issues including:. You should begin gait exercises soon after injury or illness affecting your ability to walk as long as you feel healthy enough to start the training. The process is quite similar to other forms of physical therapy, so you may use machines to help you walk safely or have your therapist assist you by supporting your bodyweight, providing stability and giving you other necessary assistance.
While you walk, observe your movements to see if you are walking out of line or imbalanced. Especially working with your doctor, you can either work on your own or with a therapist or orthotist to not only possibly have customized shoes or inserts made for you but also learn the exercises to help improve your gait. These exercises may include balance exercises—which is overall, never a bad idea. Some balance exercises include short squats while holding onto a chair or table, knee kicks and then leg kicks.
There might be certain exercises that your physical therapist or also your doctor might assign you. Work with a partner to help work on your balance once your gait improves. Try balancing on one foot and try tapping your partner or have your partner tap you around to see if you lose balance.
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