You’ve had an injury or an illness. A broken leg, traumatized pelvis or impaired spinal cord. A lower limb amputation, joint injury or muscular dystrophy. A brain injury, stroke or a neurological disorder. And you have lost your ability to stand and walk. You are desperate to get back on your feet and walk, but your muscles are weak and faulty and you can’t develop or maintain a functional walking pattern. Now, if you are such a person or know of someone struggling to walk, then gait exercises can help.
What are gait exercises?
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. Gait exercises help restore a functional gait pattern by improving muscle-activation timing—which means the time intervals between each heel’s contact with the ground. 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, 2-3 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.
You may need gait exercises after:
- Joint replacement
- Amputation
- Spinal cord injury
- Brain injury
- Stroke
- Osteoarthritis
- Muscular dystrophy
- Cerebral palsy
- Multiple sclerosis
- Parkinson’s disease
- After surgery
- Sports injury
The exercises help to improve a lot of gait issues including:
- Spastic gait - one-sided stiffness and causes a foot-dragging walk.
- Propulsive gait - a stopped and rigid posture with the head and neck bent forward.
- Scissor gait - walking with slightly bent knees and hips with the knees and thighs crossing in a scissor-like movement.
- Steppage gait - the foot hangs and the toes point down, causing the toes to scrape along the ground.
- Waddling gait - exaggerated side-to-side torso movements caused by insufficient hip stabilization.
The key benefits of gait exercises are:
- Strengthening of muscles and joints.
- Retraining legs for repetitive motion.
- Developing muscle memory.
- Improving balance and posture.
- Building endurance.
- Lowering the risk of falls while increasing mobility.
- Lowering the risk of other illnesses such as osteoporosis and heart disease through mobility and physical activity.
What does gait training involve?
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.
Commonly, the exercises involve walking on a treadmill, lifting your legs, sitting down, standing up, stepping over objects and completing various muscle strengthening activities. You may wear a harness while walking on the treadmill or during other exercises. While in other instances, your therapist may ask you to practice stepping over objects, sitting down, standing up, lifting your legs, or other activities.
Standing on one foot while lifting a weighted knee up to your hips helps to strengthen the muscles responsible for moving forward your thigh as you walk. Leg extension movements help to straighten your legs against resistance while you are in a seated position. Similarly, placing a resistance band under or above the front of your foot helps to add resistance to dorsiflexion and plantar flexion movements, respectively. And to improve balance and support a functional gait, you may engage in activities such as turning your head left and right, tilting it side to side, looking up and down while walking.
But you may also be asked to perform targeted exercises such as:
- While holding onto a sturdy desk or chair, practice standing on one leg for 5-10 seconds. Then switch the legs and take 10 repetitions.
- While lying flat on your back, try raising your knees towards your chest but with a focus at having your tummy do the work. The exercise helps to work your core muscles.
- While in a seated position, try lifting your right leg towards your chest as if marching in place. Then switch to your left leg and alternate for up to 10 repetitions.
- While seated in a chair with your feet flat, raise your toes off the ground with your heels remaining connected. You can also point your toes in order to raise your heels.
Gait exercises target the muscles responsible for walking, since it is weaknesses in these muscles that contribute to a range of walking abnormalities. For instance, the hip extensors, including the hamstrings and glutens maximums, are targeted because they are responsible for straightening the hip joint while walking.
Likewise, the quadriceps are targeted because they are the most prominent knee extensors in straightening the legs. Calf muscles such as the soleus and the gastrocnemius are targeted because they are responsible for the plantar flexion that occurs with every footstep. The dorsiflexor muscles found at the shins are also targeted because they help flex the ankle and point the top of the foot up with every forward step.
In every case, the exercises are designed to strengthen the muscles, boost posture and develop muscle memory that helps to restore mobility. Equally, the exercises reduce the likelihood of having a fall due to instability or lowered mobility when walking. But before you can get started with gait exercises, you should evaluate your safety doing the exercises without aggravating your injury or condition.
Most often, gait exercises are performed using assistive devices, particularly if you have had a surgery, leg injury or balance and strength impairment. However, while the exercises are done with treadmills, parallel bars and support systems, the aim of the training is often to reduce your dependence on such devices in order to walk more in your daily devices.
Well, you can do these exercises at home, possibly with minimal assistance from family or friends. But there is no substitute for working with a skilled, experienced, knowledgeable and reputable physical therapist. At FYZICAL Sarasota Downtown, we provide a wide range of physical therapy and orthopedic rehabilitation exercises that are effective in regaining of balance and posture and help patients to walk comfortably after injury or illness. For more information on our full range of services, visit our website or a FYZICAL location near you.