Robotics-supported therapy

Gait Training

Gait training is a type of physical therapy focused on helping patients improve their walking ability, gait pattern, endurance and gait speed. This form of therapy is suitable for patients who are impaired in their ability to walk due to neurological conditions or injury. These conditions include:

• Stroke
• Spinal cord injury
• Parkinson’s disease
• Multiple Sclerosis
• Cerebral palsy

Repetition and intensity of the gait training are critical factors in successful rehabilitation, as the process involves muscular strengthening and neurological changes. Depending on the underlying condition, the therapist at Kliniken Schmieder will devise an array of exercises individually and specifically for the patient in order to train and continuously improve strength, balance or coordination.

At Kliniken Schmieder, we use the Lyra gait trainer – a computerized walking machine including parallel bars and overhead holds. The Lyra-Trainer generates the individual human gait pattern using a mechanism that can be customised for each individual patient. The flexible adjustment of training parameters such as weight relief, footstep length and speed means that patients can be optimally challenged according to their individual motor requirements.

How Does Gait Training Work?

To begin rehabilitation, patients must be healthy and active enough to perform physical activities and movements partially independently. The Lyra-Trainer can take the weight off the rehabilitant’s body if necessary. However, patients must still be able and strong enough to move their feet and hold part of their weight.

Gait training typically involves walking on a treadmill alongside other muscle-strengthening exercises. Patients wear a harness while walking on the treadmill. When the rehabilitation patients are physically strong enough, the therapist will ask them to practice lifting their legs, stepping over objects, standing up, and other everyday activities.

Like all forms of exercise, gait training works on the principle of repetition. Starting small, patients will undergo routine walking sessions to rectify specific gait abnormalities, improve gait mechanics, and strengthen their muscles. The therapist at Kliniken Schmieder gradually increases the targets in each therapy session in order to achieve the targeted strength, balance and coordination goals.

All training data and training logs from the Lyra-Trainer are sent directly to the therapist’s tablet, where they can access and modify the training analysis at any time. The patient’s gait is analysed, assessed, and adapted using individual exercises throughout the therapy.

Expected Results

Gain training is a highly effective treatment for patients with sensorimotor and musculoskeletal disorders due to their neurological diseases. Regular therapy sessions will improve gait mechanics and strength of the muscles and reduce the risk of falls. Patients can expect improved walking speed, endurance, balance, and coordination; pain and fatigue reduction while walking is also common. Over time, patients can walk longer distances at greater speeds, potentially without the need for support, e.g., walking frames or sticks.

A wealth of evidence supports the use of gait training in numerous conditions. Not only does this treatment reduce the risk of future injuries, but it also ensures patients can perform daily activities that require standing or walking.

In one analysis, post-stroke improvements in motor activities, like walking and standing, were observed following gait training. The analysis stressed the importance of muscle strengthening, particularly in asymmetric weakness.

Indeed, gait training in hemiplegia (one-sided weakness) significantly increased weight-bearing on the affected side, stride symmetry, and normalization of gait patterns.

As Johannes Danke, our Head of Physiotherapy, advises:

In short, practice makes perfect. Through regular, intensive therapy sessions, patients strengthen muscles and rewire neurological pathways, resulting in significant strides in gait progress. Patients who undergo gait therapy at Kliniken Schmieder experience increased independence and quality of life and a reduced risk of falls, even on unsteady surfaces.

References:
Beyaert et al. (2015): Gait post-stroke: Pathophysiology and rehabilitation strategies
Mauritz (2002): Gait training in hemiplegia