The loss of function in a lower extremity can be debilitating and impact every facet of your life. Fortunately, there are many ways to alleviate the loss of function and mobility, one of them being gaiting training. The word gait means the way an individual walks. Therefore gait training refers to training someone how to walk or to walk a certain way. Gait training is considered a kind of physical therapy that strengthens and improves your ability to stand and walk. It is often recommended by a doctor after an illness or an injury has occurred which impairs someone’s ability to get around. You can also perform these exercises in combination with other types of physical therapy and treatments. Gait training will help you or your loved one walk independently and confidently, with and without the help of an adaptive device. People who can greatly benefit from gait training include those suffering from:
It is important to note, however, that everyone can benefit from gait training exercises. It is especially beneficial for elderly people who are starting to have reduced mobility in their lower limbs. Let’s touch on some of the benefits of gait training exercises:
Choosing to keep moving rather than choosing to be immobile is always a good decision. This will improve your overall health, and thus enable you to live longer, happier, and healthier. In this article, we will analyze gaits and various types of them, weight-bearing status, assistive devices, and finally gait training exercises that help with mobility.
So walking is as easy as putting one foot in front of the other right? When we break it down we see that it is not that simple. So many muscles, bones, joints, and neurological impulses all work together to create this precious movement. Gait abnormalities will occur if even one of these components fails. It is important to figure out where exactly your issue is coming from to fix the problem.
A gait cycle is a summation of several movements that occur when moving your leg to a certain position as you walk. A normal gait ambulation cycle occurs from the point your foot leaves the ground to the next time it leaves the ground again. The gait cycle is broken down into two phases: the swing phase and the stance phase. Each of these phases is also broken down further based on the way the foot is positioned during the phase.
Stance: The stance phase starts when the foot reaches the ground and the bodyweight is shifted to that anchor. Next comes the four intervals: load response, midstance, terminal stance, and pre-swing. Load response is when all the weight is put on the single foot and the other foot starts to lift off the ground in its swing phase. Midstance occurs when all the weight is on one foot while the other is completely off the ground. The terminal stance is when the heel of the standing foot is beginning to lift off of the ground. The pre-swing occurs when the toe of the standing foot comes off the ground and the weight is transferred to the previous swing foot.
Swing: This phase occurs when the foot is not in contact with the ground and is broken down in three intervals: initial swing, midswing, and terminal swing. Initial swing is when the foot is taken off the floor. During midswing, the foot is completely off the ground, moving in the air. Then in the terminal phase, the swing foot plants back on the floor and begins its stance phase.
Undergoing a gait analysis of your movement patterns by your clinician may identify a certain troublesome gait pattern you are experiencing. Here are some examples of gait problems you may be experiencing:
Your doctor or physical therapist will examine your gait and also determine your weight-bearing status. Then they will instruct your new gait based on this status. Weight-bearing status means how much body weight can be supported by the legs, coordination, and strength. You must be aware of your weight-bearing status so you do not further injure yourself. It is also possible that this status is likely to change during your treatment, due to improvement in your condition. Your doctor will oversee any changes to weight-bearing status and instruct you when it is ok to make this change. Here are the four possible weight-bearing statuses:
When it comes to gait training, it is best to start early. Your DPT will probably recommend that you start gait training as soon as you can after an injury or illness has affected your walking ability. The first task is to build muscle strength. Make sure that you are healthy enough to begin. As long as your joints are healthy and strong enough to support these new movements, you can begin at any time. Throughout the gait training process, you will be focusing on strengthening specific muscles. Focus on movements that are repetitive to build up your muscle strength.
After you have built up some strength in your muscles, then you can focus on task-specific training. This will all depend on your goal. If you have an illness or injury, your training will be centered around what needs improvement. Consult with your doctor or physical therapist about what kind of training is best for your needs.
Gait training is a commitment. You will not see improvement if you do not put in consistent work into strengthening and training your muscles. Be aware that the process can be challenging, both physically and mentally. However, with the right mindset and showing up every day to do the work, you will see results guaranteed.
Gait training exercises usually include walking on a treadmill and muscle-strengthening activities. However, the type, intensity, and duration of your gait training all depend on your diagnoses and what you are physically able to do. It is often necessary for some people to utilize assistive devices to better help them strengthen and train their muscles.
Assistive Devices: You may be given an assistive device to help maintain a regular gait cycle or to keep balance. This is especially prevalent when you have had surgery, a leg injury, or balance and strength impairment. Assistive devices may also be deemed necessary for those that have a loss of perception in their legs, weakness in the legs, walking pain, susceptible to falls, and more. Having an assistive device will provide support and can protect and prevent your legs from getting more injured. However, the goal is to strengthen your legs enough to where you have less dependence or no longer need these devices. Here are some common assistive devices that may be helpful:
These exercises target the muscles that enable you to walk. Knowing your target muscles can help you build a strength training program that will most efficiently suit your gait training needs. The hip extensors, hamstrings, and glutes are the muscles responsible for straightening the hip joint while you walk. The quads should also be targeted due to their knee activation when straightening the legs. Calf muscles enable the plantar flexion for each footstep. And lastly, the dorsiflexor muscles of your shins enable your ankle to flex.
Your gait training program should be specifically suited to your needs. But before starting your exercise program, you should be confident that your joints are strong enough. You can start priming your muscles by doing simple stretches every day. You can also try a stationary bike. This will keep your muscles active. It is best to avoid sitting for too long due to pain and stiffness that may occur. So now that we have a basic knowledge of gait training and what it entails, let’s go through some of the common gait training exercises that will help with mobility:
Utilizing a harness while treadmill training can give body weight support to help you mimic a normal walking gait. This locomotor training exercise has been an especially helpful tool for those with neurological disorders. Decreasing the load on the limbs reduces energy expenditure. With the external support of the harness, the person can control their posture and then concentrate their physical energy on step-taking.
If you do not have access to a treadmill or harness, simply focus on taking a walk every day to the best of your ability. Then, gradually over time, begin to make the walks more challenging. You can start to increase your walking speed over short distances. You can change your walking direction, such as backward, or side-stepping. You can increase your step length. You can try turning your head right to left, side to side, and up and down. You can hold items for added weight as you walk. You can increase your coordination by walking to the beat of some music. You can become more agile by walking in a circle pattern.
The more you walk, the more your muscles will be trained to work for you. Do not be discouraged by slow progress. Just making the effort will make a difference over time. Combined with the following strength training exercises, you will no doubt be happy with your improvement.
This exercise not only improves the leg strength you need for walking, it enables you to get up easier from low chairs or soft couches. Similar to squats, this exercise improves leg strength, functional balance, and control. Not only that, you aren’t at risk of getting hurt while doing this exercise. Your quads, hamstrings, and glutes, and the targets in this exercise.
Not all walking surfaces are smooth. For this reason, it is important to be able to lift your legs to step over objects. Therefore the best practice for this is to step over objects. This will also keep you from shuffling your feet, which can sometimes cause trips and falls. Therapists will often use foam objects spaced a foot or so apart to help you practice your agility while improving balance. If you do this at home, be sure to have a railing or something you can hold onto to keep your balance. This technique has been proven to be especially helpful for those who have suffered damage to the nervous system, as with stroke patients.
This exercise helps strengthen the quads, abs, and hip flexors. The ab muscles are used isometrically to stabilize the body during the motion, therefore the rectus abdominal muscle and the internal and external oblique muscles are strengthened. Consistently repeating this exercise over time will help you gain strength and to walk with greater ease. Many variations can be done once you have mastered this one.
Single leg stances are an effective method to incorporate into your balance training. This is an incredibly simple and basic exercise. However, you must master it to improve your balance and decrease the risk of falls. Make sure your breathing is normal, calm, and controlled.
As your strength increases, you will be introduced to more and more exercises that will improve your strength, balance, and mobility. You can also incorporate the use of free weights, resistance bands, or ankle weights for some added challenge. Always listen to your body and make sure you are not taking on more than you can handle. If something is too much, stop, take a break. Little by little you will get to where you want to go.
We hope these gait training exercises are the beginning of your journey to increased motor control and mobility. Gait training exercises can be difficult, especially if you are coming out of a very traumatic illness or injury and are relearning how to walk. The process of recovery can take a while, sometimes even longer than we expect. Keep in mind that this is a mental health care challenges as well as a physical one. The stronger your belief in your improvement, the more likely it will occur. Make sure that every step of the way is guided by a physical therapist or doctor. This will eliminate any potential hazards and roadblocks to your recovery. Health care staff will go over your condition, your gait training plan, and long-term outlook. We here at CareAsOne believe that being surrounded by a strong support network and keeping a strong positive outlook will get you through your gait training process and recovery.