Locomotor training

Question 1

Locomotor requirements for walking

Answer 1

• ability to support body weight on the LE
• ability to generate rhythm required for walking
• Dynmic postural control
• movement of body in the intended direction
• adaptability under changing conditions and demands

Question 2

Outcome measures

Answer 2

• observation
• gait speed
• gait distance
• postural control

Question 3

Practice for gait

Answer 3

• variable and massed :500-600 repetitiions per session
• random
• whole training

Question 4

feedback for locomotor training and gait

Answer 4

• knoledge of results and knowlegde of performance
• faded/bandwidth/summed
• intrinsic vs extrinsic
• can they fix it themselves
• avoid too much of a good thing

Question 5

What are key motor learning and neuroplasticity principles for locomotor rehab

Answer 5

• task-specific practice with a high number of reps is critical
• variable and random practice promotes motor learning
• summary and faded knowlede of results feedback promotes learning
• feedback is beneficial for motivation
• external focus of attention
• provide control and autonomy to the patient
• high intensity
• challenging and engaging to the patient
• goal directed and meaningful to pt

Question 6

what is body-weighted supported gait training

Answer 6

• unweighted: starting with 30-40%
• as much weight as patient can tolerate without UE support
• therapist assist with LE and trunk control
• treadmill or overground

Question 7

treadmill training for gait

components to think about

Answer 7

• rhythm
• variability
• massed practice

Question 8

clinical practice guidelines for locomotor training

Answer 8

1. moderate to high intensity gait training: strong evidence for patient post CVA
2. virtual reality training: strong evidence for patients post CVA
3. strength training: clinicians may consider strength training to improve walking speed and distance but this has weak evidence overall
4. cycling interventions: improve gait speed and distance
5. circuit combined training: uses aerobic, balance, and strength exercises, to improve gait speed and distance
6. balance training:
7. body weight supported treadmill traing
8. robotic assisted gait training

*recommendations for individuals more than 6 months post injury

Question 9

is balance training good for locomotor and gait training

Answer 9

• SHOULD NOT use sitting or standing balance balance training to improve postural stability and weight bearing symmetry during gait to improve gait speed and distance
• clinicians may consider static and dynamic balance strategies coupled ith VR or augmented visual feedback to improve gait speed and distance post stroke

Question 10

is robotic assisted gait training good for walking/what compnrents of gait does it help

Answer 10

• clinicians should not use BWST or RAGT to improve gait speed and distance
• overall doesnt help gait speed
• types: lokomat, zero G
• exoskeleton: lifeward robotics, indego: ekso bionics