After over a year and half we finally came back to our gym in Lexington at the Cotting school for in-person gait training. While training everyone in this program virtually during that time, we had a chance to re-think our training and consult with therapists about new developments in the field as well as our team. We decided that even with sessions lasting an hour we should devote part of the time with ground based training that would give our athletes a chance to employ the benefits of our Gait Trainer device. As example, most of our athletes have a need to improve hip abduction or Trendelendburg gait. The trick is employing motion or strength learning in exercise in actually walking. We begin each session with work at a bar and hip abduction and knee flexion, hip extension/flexion stretch and exercise. *
After 20 to 30 minutes on the Gait Trainer we walk in hopes that the exaggerated or perfect walking on the treadmill and our device, will translate into the same as we walk freely right afterwards. Most see an immediate benefit and spill over from the time on the device with uniform length of gait and improved hip and knee flexion with a good bilateral heel strike. The trick is to continue this with an almost conscious effort afterwards. We’re using some devices like THENEWGAIT to assist in that prompting with great success. This device helps reinforce the form for which we train on our device and treadmill. See these videos of two of our all stars, one getting assistance with knee flexion and the other with internal rotation.
*For those of you who aren’t familiar, here are some of the larger issues which we deal with in improving gait:
- Circumduction – Especially with people who have had a stroke or one sided weakness, the body figures a way to ambulate. That often includes this way of leaning of to the side of a stronger leg in order to swing the weaker around and forward.
- External rotation – Often accompanying circumduction, some turn their foot outwards in order to clear the ground as they swing forward. The rotation may come from the hip or ankle but this is difficult to overcome.
- Knee Flexion and Hip Flexion – Many of our athletes or “clients” have difficulty in lifting a weaker leg forward. Circumduction occurs when this weaker leg stays straight. Some learn to flex or bend at the hip but the knee remains straight or extended (extension).
- Hip Abduction/Trendelenburg gait – When people have weak or inactive hip abductors they can’t move their leg outwards as they stand or walk. Some of our athletes try to overcome this by turning outward with their body or rotating their foot outwards and using their hip flexors to do the job. This is probably the most common issue we encounter as people with weak abductors (especially their gluteus medius, minimus, and tensor faciae latae). When exercising this we emphasize straight legs to employ those muscles only, but putting this into walking practice is extremely difficult.