What is Gait and How Home Physical Therapy Can Help
15/01/11 10:16
The pattern of how a person walks is called their gait. Many different types of walking abnormalities are produced unconsciously. Most, but not all, are due to some physical condition.
Some walking abnormalities are so characteristic that they have been given descriptive names:
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Treatment of the cause often improves the gait. For example, gait abnormalities from trauma to part of the leg will improve as the leg heals.
For an abnormal gait that occurs with conversion disorder, psychiatric counseling as well as support from family members is strongly recommended.
For a propulsive gait:
Original article: http://www.nlm.nih.gov/medlineplus/ency/article/003199.htm
Some walking abnormalities are so characteristic that they have been given descriptive names:
- Propulsive gait -- a stooped, rigid posture, with the head and neck bent forward
- Scissors gait -- legs flexed slightly at the hips and knees, giving the appearance of crouching, with the knees and thighs hitting or crossing in a scissors-like movement
- Spastic gait -- a stiff, foot-dragging walk caused by one-sided, long-term, muscle contraction
- Steppage gait -- foot drop where the foot hangs with the toes pointing down, causing the toes to scrape the ground while walking
- Waddling gait -- a distinctive duck-like walk that may appear in childhood or later in life
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Treatment of the cause often improves the gait. For example, gait abnormalities from trauma to part of the leg will improve as the leg heals.
For an abnormal gait that occurs with conversion disorder, psychiatric counseling as well as support from family members is strongly recommended.
For a propulsive gait:
- Encourage the person to be as self-reliant and independent as possible.
- Allow plenty of time for daily activities, especially walking. People with this problem are susceptible to falls because of poor balance and an unconscious effort to always catch up.
- Provide walking assistance for safety reasons, especially on uneven ground.
- Consult a physical therapist about exercise therapy and walking retraining.
- Loss of skin sensation is often associated with scissors gait, so skin care should be provided in order to avoid skin breakdown and ulcers.
- Leg braces and in-shoe splints can help maintain proper foot alignment for standing and walking. A physical therapist can supply these and provide exercise therapy, if appropriate.
- Both active and passive exercises are encouraged.
- Leg braces and in-shoe splints can help maintain proper foot alignment for standing and walking. A physical therapist can supply these and provide exercise therapy, if appropriate.
- A cane or a walker is recommended for those with poor balance.
- Adequate rest is encouraged. Fatigue can often cause an affected person to stub his toe and fall.
- Leg braces and in-shoe splints can help maintain proper foot alignment for standing and walking. A physical therapist can supply these and provide exercise therapy, if appropriate.
Original article: http://www.nlm.nih.gov/medlineplus/ency/article/003199.htm
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Timed Up and Go Test
19/12/10 10:02
At Distinctive Home Physical Therapy, we use the “Timed Up and Go Test” to gauge our patient’s range of mobility and as a fall prevention strategy.
Here’s an overview of the test:
Patients are instructed to stand up and walk 10 feet as fast but as comfortable as possible. They are then asked to sit down. A score greater than 14 seconds indicates a high risk for falls in the elderly.
Call us today to have your balance checked and to determine your fall risk level!
Here’s an overview of the test:
Patients are instructed to stand up and walk 10 feet as fast but as comfortable as possible. They are then asked to sit down. A score greater than 14 seconds indicates a high risk for falls in the elderly.
Call us today to have your balance checked and to determine your fall risk level!
Study: Walking Again After a Stroke Using a Treadmill
03/12/10 10:40
Walking After Stroke: What Does Treadmill Training With Body Weight Support Add to Overground Gait Training in Patients Early After Stroke?
A Single-Blind, Randomized, Controlled Trial
Marco Franceschini, MD; Stefano Carda, MD; Maurizio Agosti, PT; Roberto Antenucci, MD; Daniele Malgrati, MD; Carlo Cisari, MD on behalf of Gruppo Italiano Studio Allevio Carico Ictus (GISACI)
Background and Purpose— This study aimed to assess the effectiveness of gait training using body weight support on a treadmill compared with conventional gait training for people with subacute stroke who were unable to walk.
Methods— This was a single-blind, randomized, controlled trial with a 6-month follow-up. Ninety-seven subjects were recruited within 6 weeks of stroke onset and were randomly assigned to conventional rehabilitative treatment plus gait training with body weight support on a treadmill (experimental group; n=52) and conventional treatment with overground gait training only (control group; n=45). All subjects were treated in 60-minute sessions every weekday for 4 weeks. Outcome measures were Motricity Index, Trunk Control test, Barthel Index, Functional Ambulation Categories, 10-meter and 6-minute Walk Tests, and Walking Handicap Scale. Assessments were made at baseline, after 20 sessions of treatment, 2 weeks after treatment, and 6 months after stroke.
Results— After treatment, all patients were able to walk. Both groups showed improvement in all outcome measures (P<0.0063) at the end of the treatment and at follow-up. No differences were seen between the 2 groups before, during, and after treatment and at follow-up.
Conclusions— In subacute patients with stroke, gait training on a treadmill with body weight support is feasible and as effective as conventional gait training. However, the need for more personnel for treadmill training makes the use of robotically assisted systems more compelling.
Original article: http://stroke.ahajournals.org/cgi/content/short/40/9/3079
A Single-Blind, Randomized, Controlled Trial
Marco Franceschini, MD; Stefano Carda, MD; Maurizio Agosti, PT; Roberto Antenucci, MD; Daniele Malgrati, MD; Carlo Cisari, MD on behalf of Gruppo Italiano Studio Allevio Carico Ictus (GISACI)
Background and Purpose— This study aimed to assess the effectiveness of gait training using body weight support on a treadmill compared with conventional gait training for people with subacute stroke who were unable to walk.
Methods— This was a single-blind, randomized, controlled trial with a 6-month follow-up. Ninety-seven subjects were recruited within 6 weeks of stroke onset and were randomly assigned to conventional rehabilitative treatment plus gait training with body weight support on a treadmill (experimental group; n=52) and conventional treatment with overground gait training only (control group; n=45). All subjects were treated in 60-minute sessions every weekday for 4 weeks. Outcome measures were Motricity Index, Trunk Control test, Barthel Index, Functional Ambulation Categories, 10-meter and 6-minute Walk Tests, and Walking Handicap Scale. Assessments were made at baseline, after 20 sessions of treatment, 2 weeks after treatment, and 6 months after stroke.
Results— After treatment, all patients were able to walk. Both groups showed improvement in all outcome measures (P<0.0063) at the end of the treatment and at follow-up. No differences were seen between the 2 groups before, during, and after treatment and at follow-up.
Conclusions— In subacute patients with stroke, gait training on a treadmill with body weight support is feasible and as effective as conventional gait training. However, the need for more personnel for treadmill training makes the use of robotically assisted systems more compelling.
Original article: http://stroke.ahajournals.org/cgi/content/short/40/9/3079