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Gait training


Gait training or gait rehabilitation is the act of learning how to walk, either as a child, or, more frequently, after sustaining an injury or disability. Physical therapists, or physiotherapists, generally help their patients with gait training.

Gait training can take a number of forms, but repetition of the actual motions performed during walking is the most important factor. Parallel bars may be used to help with gait training, especially in the early stages when a patient is first learning or re-learning to walk. They involve a person walking between two handrails to support themselves, often with the therapist either helping to support the patient or physically moving the patient's legs. Gait trainer or other gait aids are also utilized.

In recent years there have been advancements in how the patient can increase the duration of therapy safely to make for more effective treatment. Body-weight support (BWS) systems or unweighting devices are starting to become more and more popular and have been the subject of much study. BWS systems can be used prior to the patient gaining adequate motor control or having sufficient strength to fully bear weight. The patient will wear a specialized trunk harness with adjustable straps, which attach to an overhead suspension system. The harness and its attachments support a certain amount of the patient’s body weight. Gait training techniques that utilize a BWS system appear to be promising in their ability to improve and possibly restore walking function, as demonstrated in individuals suffering from incomplete spinal cord injuries. A BWS system can be used on a treadmill or over ground for gait training. Body-weight-supported treadmill training (BWSTT) enables individuals with motor deficits that have rendered them incapable of completely supporting their own body weight to practice and experience locomotion at physiological speeds. Depending on the severity of the person's impairment, one or more physiotherapists may be present to assist in maintaining the patient’s appropriate posture and moving their legs through as kinematically physiological a gait pattern as possible. Recently, electromechanical devices such as the Hocoma Lokomat robot-driven gait orthosis have been introduced with the intention of reducing the physical labour demands on therapists. This system uses a computer-controlled exoskeleton to repeatedly and consistently guide lower-limb movements, making BWSTT a more feasible option for long-term and widespread use.


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