The gait training is of great importance in physiotherapy. Quite unconsciously, we learn to walk as a child and do not worry about how we move in everyday life. However, as soon as injuries, orthopedic malpositions or even neurological diseases lead to limitations, these also have an enormous effect on our gait.
For example, if we have pain in our feet or knees, we limp. This is not a problem in the short term, but if we get used to a “wrong” gait in the long term, it can have a major impact on our joints and structures. The focus of physiotherapy is to develop a physiological gait pattern. If the physiological gait pattern cannot be restored due to neurological failures or irreversible orthopedic changes, the best possible compensation mechanisms must be worked out to maintain the patient’s mobility and independence and thus a high degree of quality of life.
Physiotherapeutic intervention
If the physiological gait pattern is only changed for a short period of time, e.g. after a fracture or to improve it again through targeted training (e.g. with internally rotated hips in children), this is the aim of physiotherapy. In physiotherapeutic gait training, walking itself can be practiced – this is known as gait training, or deficits such as shortened or weak muscles can be improved in isolation on the therapy bench or through functional exercises.
Frequent causes for a changed gait pattern can be weak hip muscles in case of hip joint arthrosis or shortened calf muscles after a long-term immobilization. There are many other causes that can change our gait pattern. In physiotherapy, these are analyzed on the basis of precise, individual findings and specifically improved during treatment.
A homework program with isolated exercises can also be part of the therapy. Once mobility and strength are (re)established, the movements learned in gait are applied and trained. Gait training also includes the use of aids such as crutches.
It is important to use them correctly in order to have a healthy gait pattern despite limitations, so as not to strain other structures. The article “Exercises for gait disorders” may be of interest to you in this regard. Gait training for patients with permanent limitations It is especially important for neurological patients to develop a gait pattern with which the patient can move safely in everyday life.
Often spasticity or the loss of certain muscle groups (e.g. weakness of dorsiflexion of the foot) occurs. These must be compensated. In physiotherapeutic gait training, the deficits are minimized as much as possible and then strategies can be developed that enable the patient to deal with his or her disability and move safely in spite of it.
For this purpose, aids can also be considered, such as orthoses, supports or rollators. The independence of the patient is very important. Here too, individual weak points are often isolated in exercises.
However, it is also important to apply them directly while walking. Treadmill training is ideal for this purpose. The therapist can kneel next to the patient and support him or her in walking at different speeds, while the patient can hold on tightly or even be secured by slings.
In addition, endurance and the cardiovascular system are trained. There are also modern devices in which the patient is clamped in a sling system and can relearn to walk through computer-supported training. Gait training is very important in physiotherapy, so walking is often practiced again with patients in intensive care units (e.g. after a stroke).
It is also important to maintain the ability to walk after surgical or orthopedic interventions. For example, during immobilization, care is always taken to train the muscles that are important for walking even while the patient is still in bed. Joints are mobilized so that contractures, i.e. the loss of joint mobility, are avoided.
For example, sufficient mobility in the ankle joint is important for walking. After a long period of confinement to bed, a pointed foot position often occurs, i.e. the foot can no longer be tightened.It is part of physiotherapy to prevent such changes at an early stage in order to be able to regain a physiological gait pattern later on. AidsIf contractures are present or muscle groups are paralyzed, specialists can adapt certain aids such as heel elevators, orthoses, bandages or supports to make it easier for the patient to move around independently.
It is important to have the aids fitted precisely in the case of permanent restrictions, since an inadequate fit can lead to consequential damage. The fitting and selection of aids is at best done in direct cooperation with the medical supply stores. Gait training and thus the ability to “move independently” is of great importance in physiotherapy, as this ability contributes greatly to the quality of life of patients.
Not only orthopedic or surgical clinical pictures can change the gait pattern, especially in neurology (MS, Parkinson’s) there is a lot of work on the gait pattern. This is done through isolated exercises taken out of the gait, as well as directly while walking. Treadmill training enables a very specific training.
Walking outside can also be part of the therapy. Aids can make walking easier in the short or long term. The correct use of aids can also be learned during therapy. In addition to increasing the strength of the ankle, knee and hip muscles, it is particularly important to improve/restore coordination and balance.
