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gait training

Gait Training in Stroke

19th June 2019

A stroke can hamper a person’s daily living ability at various levels. Both physical and mental aspects of life get affected, reducing the person’s confidence levels to perform any sort of living activity on their own.

The ideal societal communication and living parameters that determine the number of words per minute, the walking speed and the decision making ability will need to be rechecked for the stroke survivors.

Rehabilitation for Stroke –

Rehabilitation therapy for stroke patients focuses on restoring the functionality of the affected organ with the help of therapy sessions by a team of rehabilitation experts.

Continue reading this blog that focuses on the gait technique, employed to improve the person’s walking ability.

Gait Training – Motor impairments is one of the major affected aspects of the body after stroke. The term gait refers to the way a person walks and the pace of the walk.

The team of rehabilitation therapists will first analyse the person’s walking style and the coordination of all muscles to measure the impact. Gait training is employed in the event of the following impairments.

  • When you have paralysis or stiffness of the legs
  • When you have involuntary movements or poor co-ordination of the legs

The rehabilitation experts will conduct various tests, mostly exercises to understand and to device the rehabilitation plan. The goal will be to:

  • Increase brain and limb coordination
  • Increase flexibility and balance
  • Increase responsiveness and mobility in the lower limbs

Therapy for Impaired Gait –

It leverages the brain’s nature of the more you practice, the more it rewires itself accordingly. The exercises are mainly focused on repetitive task based activities such as walking, cycling, functional activities and strengthening of the muscles of the legs.

Walking and cycling:

Research has shown repeatedly that repetitive activities help the most with brain injury. These repetitive activities have to be functional in nature and not just mere passive movements of one’s limbs. Walking and cycling are good examples of repetitive task based activities. Depending on an individual’s extent of injury these activities can be done alone, or with some assistance or with complete assistance.

Functional activities:

In par with walking and cycling, repetitive activities such as sitting to standing, standing with or without support, balance activities such as kicking a ball with unaffected leg while bearing weight on the affected leg help improve recovery of function in the affected limb. One may require complete assistance in doing these activities in the beginning stages but when they are done hundreds or thousands of times the improvement is noticeable. 

Strengthening of the muscles of the legs:  

These exercises help strengthen the muscles that are weak due to stroke. They are not often done in the initial stages of stroke when someone is completely paralysed. It is mostly done when an individual has improves to some extent but not completely. Although each individual should have custom made exercise protocol based on the recovery process here are a few examples of exercises that can help you in building strength and improving the muscle and brain coordination.

  • To Improve Core Strength –
  1. Toe Taps –

Lie down on your back and lift your knees at 90 degree angle. The shins should be parallel to the ground. The weight should be equally distributed. Now, gently lift your left leg up and maintain 90 degree position. Then, repeat the same with the second leg.

  1. Knee to Chest –

Lie down on your back with the legs stretched forward. Slowly lift your left leg, bend the knee and hold it firmly with your both hands. Now, bring the knee close to your chest. Now repeat the same with the other leg.

  • To Improve Leg Muscles –
  1. Seated Marching –

Sit in a chair in a comfortable position with both feet touching the ground.  While keeping your back erected, slowly lift your left leg up and bring it down. Repeat the same with the other leg as well. 

  1. Knee Extension –

Sit on a chair, keeping the legs down and hands on thighs. Now stretch each leg towards up without bending the knees. Repeat the same with the other leg. This improves the muscle flexibility.

  • To Improve Foot Muscles –
  1. Toe Raises –

Be in a seated position keeping the body weight on both feet equally. Now, try to lift the right foot toe up along with the other fingers. Repeat the same with the other leg as well.

  1. Heel Raises –

Sit in the same posture as toe raises. But in this exercise, you need to lift the heels up. You could lift one heel at a time or both at a time. 

The therapy sessions consist of re-linking your mind to your muscles otherwise called neuroplasticity. Neuroplasticity in the lower limb only happens when the repetitive activities are task based such as walking, cycling, sit to stand, standing, and weight shifting. Strengthening exercises are ideal only after an individual has regained some movements in the legs. Merely having someone else passively move the legs do not help with neuroplasticity.