Gait Training: The Next Step
- By Laurie Watanabe
- Apr 01, 2010
Q&A with Lori Potts, PT, Rifton
Q: What conditions or diagnoses can benefit from gait training?
Lori Potts: Any child or adult who is unable to walk independently
may benefit from gait training. Diagnoses include neuromotor impairments
such as cerebral palsy and other developmental disabilities. In
adult neurorehabilitation, gait training is appropriate for individuals
who have had a stroke, traumatic brain injury or spinal cord injury that
resulted in motor deficits affecting their ability to walk. Gait training
can occur over a treadmill with a body-weight-support system, and/or
gait training can occur over ground with a supportive gait device.
Q: What are the major goals of a gait-training program, besides the
obvious goal of walking?
LP: The goals include improving an individual’s walking ability to
progress them to increased independence in walking with the use of
the least possible assistance. Progression from body weight support
treadmill training (BWSTT) to over-ground gait-device training occurs
with ongoing reduction of assist and support. This can result in either
independent gait or independent walking with a cane, crutch or standard
walker in both children and adults.
These functional gains through improved weight-bearing, core
stability and balance may also result in increased independence and
reduced assistance required for other activities of daily living, such
as transfers. Improvements in gait balance, speed and individual
confidence in walking can be achieved through gait training, even if
complete independence from a device is not.
Q: What emotional, social and cognitive benefits can develop as a
result of gait training?
LP: Gait activity provides an upright physical activity at eye-level with
peers. The possibility of freedom of movement in natural environments
has emotional and social benefits through the possibility of
choice-making. For individuals with cognitive deficits, the possibility
of learning through movement includes spatial awareness and motionbased
cause and effect. Research is indicating that independent mobility
at an early age may have a significant beneficial impact on cognition.
Q: How does a gait trainer work?
LP: There are many designs of gait-training devices. Essentially, these
devices provide weight-bearing assist in some measure for individuals
who cannot stand independently due to lack of weight-bearing ability
through their lower extremities.
These devices also provide support that aligns the trunk and pelvis
as needed to maintain the upright position and body balance over the
individual’s base of support. Gait devices often include support for the
upper extremities that serves as both weight-bearing assist and balance
support. Further accessories assist leg positioning and alignment for
step-taking. The amount of assistance and support can be decreased as
the user gains skills and improves their independence in gait.
This article originally appeared in the April 2010 issue of Mobility Management.
Laurie Watanabe is the editor of Mobility Management. She can be reached at firstname.lastname@example.org.