Evidence Based Practice - Gait re-education

Question 1

What are the predictors for good gait recovery in stroke?

Answer 1

Early standing and stepping practice

Question 2

What are the principles of ground surface gait training?

Answer 2

Practice walking over a range of surfaces - make specific to patients needs
Allows for observation and manipulation during practice
Part and whole practice

Question 3

What are the benefits of treadmill training?

Answer 3

Able to manipulate the walking speed and increase duration of practice (e.g. can complete high reps)
Gait can be observed and manipulated
Can gradually increase the intensity

Stride length is shorter but the cadence is higher - so should be used in conjunction with ground walking

Question 4

What is bodyweight supported treadmill training and what is the benefit?

Answer 4

Percentage of the bodyweight is removed to allow the patient to walk when otherwise couldn’t

Requires two therapists to support paretic limb and maintain balance

Over time percentage can be reduced and intensity increased

Best results if within 3 months post-stroke

Question 5

What is the benefit of circuit class training for gait?

Answer 5

Allows for high repetitions of training
Practising part of the treatments
Can be individually tailored and progressive
Positive outcomes observed - walking speed, distance, balance and walking ability

Question 6

What are the important parts of part practice for gait?

Answer 6

Toe off - plantarflexion for propulsion

Coordination of hip and knee movements for swing phase