The document outlines key components for effective gait training, emphasizing the importance of initial prerequisites such as bed mobility and balance training. It details various methods including body-weight support systems, functional electrical stimulation, and the use of assistive devices to improve walking capabilities. Additionally, it highlights the significance of outdoor training in realistic environments to enhance adaptability and safety during gait rehabilitation.

1. Gait training

2. Gait Pre- requisites
• Bed mobility
• Sitting balance
• Sit to stand
• Standing balance- start on a parallel bar progress to assistive aids and
independent walking

3. How to initiate gait as early as possible?
• BWS - treadmill and over ground walking
• The overhead harness helps- gradual
loading of the weak limbs.
• Avoids excessive upper limb loading while
training.

4. ! Identify the impairments !
Management
Restorative Compensatory

5. Restorative
1. Tone management
2. Stretching
3. Facilitation/ Strengthening
4. Stimulation- Functional Electrical stimulation
5. Break down phases of gait and retrain phase wise
6. Working on the spatiotemporal parameters

6. STIMULATION- Functional Electrical Stimulation

7. Break down phases of gait and retrain phase wise
• Give verbal, visual or tactile cues during walking.
• Ex-
• walking on heels
• marching with exaggerate hip flexion to facilitate hip flexion during swing

8. Working on the spatiotemporal parameters
• Give verbal visual cues

9. COMPENSATORY
• Orthosis
• Assistive devices- walker, crutches, or quadpod.

10. Functional gait training
Adaptability of gait-
• Walking side ways, backways
• Walking over obstacles
• Taking pivot turns
Dual tasking-
• Walking talking
• Walking while looking around

11. OUTDOOR TRAINING
• Dynamic, real life environment.
• Training here is more meaningful for the patient.
• EX-
• uneven roads, climbing curbs, walking in crowded places, walking while holding onto his bag,
crossing roads.
SAFETY OF THE PATIENT IS THE PRIORITY

12. REFERENCES
• Physical rehabilitation. O Sullivan 6th edition
• Motor control Anne Shumway cook

13. THANK YOU