Gait training intervention for people with Cerebral Palsy
By Toby Doevendans
Accredited Exercise Physiologist
What is Gait training?
Gait training is a modality used in physical therapy to help improve your ability to walk. Gait training can help to improve independence in movement and reduce the risk of falls or injury. An Exercise Physiologist will utilise gait training to assess, alter and improve a person’s ability to stand and walk in alignment. Gait training predominantly involves walking on a treadmill to complete aerobic and endurance tasks. It may also utilise a ceiling hoist or LiteGait walking system to complete the exercise in a safe environment with no risk of falling.
Effects of impaired walking gait in people with Cerebral Palsy
Abnormal gait in people with Cerebral Palsy is often due to the damage of the Central Nervous System (CNS) including the loss of selective muscle tone and relative imbalances between muscle agonists and antagonists across joints. Impaired gait ability can have a significant impact on your quality of life, ability to integrate with peers and participation in the community. Gait function can deteriorate with age and this may decrease a person’s physical independence.
One of the biggest barriers for people living with Cerebral Palsy is muscle spasticity. Muscle spasticity increases associated pain, contractures and subluxation of joints depending on the severity of spasticity. As a result of the spasticity experienced by individuals with Cerebral Palsy, impairments in gait are often associated with a decrease in functionality and movement. It is important to manage spasticity and decrease muscle tone to help improve a person’s overall movement.
Gait training for Cerebral Palsy
Functional gate training is a safe and effective method aiming to improve walking ability in children and adults with Cerebral Palsy. Research suggests this is the most effective evidence based treatments to improve walking through the promotion of neuroplasticity during functional training.
Neuroplasticity is the brain’s ability to make new connections and rewire itself which can help improve damage to the brain. The reason behind gait training promoting neuroplasticity, is that a person can perform repetitive stepping in an supported, upright neuro-typical position. This can create new neural pathways that teach the brain and body that this position is safest, pleasurable and the most energy conserving making these new pathways become stronger.
Several research studies suggest that body weight supported treadmill training has been proven to increase walking ability, speed and endurance in people with Cerebral Palsy. In comparison to conventional walking training, body weight supported treadmill training offers an increase in specific gait rehabilitation due to the client using less personal energy (due to supportive equipment) and allow them to walk faster and for a longer duration.
Gait training can play an important role in:
- Improving balance and posture
- Improving Muscle Strength
- Increasing endurance
- Improving motor patterns and neural pathways
- Improving physical independence
- Improving overall gross motor function
Gait training at Physical Evolution
Here at Physical Evolution we provide multiple assistive modalities to assess and alter walking gait patterns across a range of neurological disorders. We have research backed equipment, including the LiteGate, which can provide a safe environment for your specific gait training needs. Our team of Exercise Physiologists and Physiotherapist will be happy to give an assessment and begin to provide the most appropriate gait training therapy possible and get you stepping better today.
Please get in contact with Physical Evolution today for any inquiries into the Gait Training we provide on 07 5636 9458.
References
Booth, A. T., Buizer, A. I., Meyns, P., Oude Lansink, I. L., Steenbrink, F., & van der Krogt, M. M. (2018). The efficacy of functional gait training in children and young adults with cerebral palsy: a systematic review and meta‐analysis. Developmental Medicine & Child Neurology, 60(9), 866-883.
Dickin, D. C., Faust, K. A., Wang, H., & Frame, J. (2013). The acute effects of whole-body vibration on gait parameters in adults with cerebral palsy. J Musculoskelet Neuronal Interact, 13(1), 19-26.
Frisk, R. F., Jensen, P., Kirk, H., Bouyer, L. J., Lorentzen, J., & Nielsen, J. B. (2017). Contribution of sensory feedback to plantar flexor muscle activation during push-off in adults with cerebral palsy. Journal of neurophysiology, 118(6), 3165-3174.
Gait Training | Definition and Patient Education. (2016). Retrieved 1 December 2021, from https://www.healthline.com/health/gait-training
Gillett, J. G., Lichtwark, G. A., Boyd, R. N., Carty, C. P., & Barber, L. A. (2019). The effect of combined functional anaerobic and strength training on treadmill gait kinematics and kinetics in ambulatory young adults with cerebral palsy. Gait & posture, 70, 323-329.