Patient Cases in Gait Training

Patient I: Patient with right hemiplegia

Standing Balance Training Hemiplegia
Fig. 12.29. Patient with hemiplegia. a Getting to standing; b transfer from wheelchair to table
Gait Training Hemiplegia

□ Fig. 12.29. Patient with hemiplegia. c, d facilitation of the stance phase on the hemiplegic leg; e, f stance on the involved leg with emphasis on hip extension and knee control c f e

Patient II: Patient with ankylosing spondylitis (O Fig. 12.30 a-c).

Knee Flexion And Extension Excercise

Patient III: Patient with fracture of the right tibia, external fixation and partial weight acceptance (O Fig. 12.31 a-c).

Ankylosing Spondylitis And Legs Partial Weight Hemiplegia

□ Fig. 12.31. a Emphasis on hip extension with partial weight support; b weightbearing up to 50 % or 40 kg (80 pounds) on the involved leg; c exercise of weight shift forward a c

Patient IV: Patient with below-knee amputation of the left leg (O Fig. 12.32a-e).

Amputee Knee Women

O Fig. 12.32. a Standing up; b weight shift on the prosthesis with knee control; c standing on prosthetic leg, emphasis on hip and knee extension during stance phase; d stepping up, control with prosthetic leg; e stepping down, control with prosthetic leg

References

Adler SS (1976) Influence of "Joint Approximation" on lower extremity extensor muscles: an EMG study. Unpublished thesis presented at APTA annual conference, New Orleans

Beckers D, Deckers J (1997) Ganganalyse und Gangschulung,

Springer Verlag, Berlin Heidelberg New York Eberhart HD, Inman VT, Bresler B (1954) The principal elements in human locomotion. In: Klopteg PE, Wilson PD (eds) Human limbs and their substitutes. McGraw-Hill, New York

Horak FB, Nashner LM (1986) Central programming of postural movements: adaptation to altered support-surface configurations. J Neurophysiol 55 (6):1369-1381 Inman VT, Ralston HJ, Todd F (1981) Human walking. Williams

& Wilkins, Baltimore Lerner-Frankiel MB, Vargas S, Brown M, Krusell L (1986) Functional community ambulation: what are your criteria? Clin Management 6 (2):12-15 Murray MP, Drought AB, Kory RC (1964) Walking patterns of normal men. J Bone Joint Surg [A]:335-360 Nuzik S, Lamb R, VanSant A, Hirt S (1986) Sit-to-stand movement pattern, a kinematic study. Phys Ther 66 (11):1708-1713

Perry J (1992) Gait analysis, normal and pathological function. Slack, NJ

Podsiadlo D et al (1991) The timed "Up and go": a test of basic functional mobility for elderly persons. American Geriatrics Society 39:142-148

Further Reading

Posture Control and Movement

Finley FR, Cody KA (1969) Locomotive characteristics of urban pedestrians. Arch Phys Med Rehabil 51:423-426 Gahery Y, Massion J (1981) Co-ordination between posture and movement. Trends Neurosci 4:199-202 Nashner LM (1980) Balance adjustments of humans perturbed while walking. J Neurophysiol 44:650-664 Nashner LM (1982) Adaptation of human movement to altered environments. Trends Neurosci 5:358-361 Nashner LM, Woollacott M (1979) The organization of rapid postural adjustments of standing humans: an experimental-conceptual model. In: Talbott RE, Humphrey DR (eds) Posture and movement. Raven, New York Woollacott MH, Shumway-Cook A (1990) Changes in posture control across the life span - a systems approach. Phys Ther 70:799-807

Kettelkamp DB, Johnson RJ, Schmidt GL, et al (1970) An elec-trogoniometric study of knee motion in normal gait. J Bone Joint Surg [A] 52:775-790 Lehmann JF (1990) Gait analysis, diagnosis and management. In: Krusens handbook of physical medicine and rehabilitation, Saunders, Philadelphia, pp 108-125 Lehmann JF (1990) Lower extremity orthotics. In: Krusens Handbook of physical medicine and rehabilitation. Saunders, Philadelphia, pp 602-646 Mann RA, Hagy JL, White V, Liddell D (1979) The initiation of gait. J Bone Joint Surg [A] 61:232-239 McFadyen BJ, Winter DA (1988) An integrated biomechanical analysis of normal stair ascent and descent. J Biomech 21:733-744

Murray MP, Kory RC, Sepic SB (1970) Walking patterns of normal women. Arch Phys Med Rehabil 51:637-650 Murray MP, Drought AB, Kory RC (1964) Walking patterns of normal men. J Bone Joint Surg [A] 46:335-360 Nashner LM (1976) Adapting reflexes controlling the human posture. Exp Brain Res 26:59-72 Pohl M, Mehrholz J, Ritschel C, Rückriem S (2002) Speed dependent treadmill training in ambulatory hemiparetic stroke patients: A RCT. Stroke (33): 553-558 The Pathokinesiology Service and The Physical Therapy Department, Ranch Los Amigos Medical Center (1993) Observational Gait Analysis. Los Amigos Research and Education Institute Inc., Downey CA Smidt G (1990) Gait in rehabilitation. Churchill Livingstone, New York

Sutherland DH (1966) An electromyographic study of the plantar flexors of the ankle in normal walking on the level. J Bone Joint Surg [A] 48:66-71 Sutherland DH, Cooper L, Daniel D (1980) The role of the ankle plantar flexors in normal walking. J Bone Joint Surg [A] 62:354-363

Sutherland DH, Olshen R, Cooper L, Woo SLY (1980) The development of mature gait. J Bone Joint Surg 62:336-353 Wang RY (1994) The effect of proprioceptive neuromuscular facilitation in case of patients with hemiplegia of long and short duration. Phys Ther 1994 (12): 25-32 Winter D (1989) The biomechanics and motor control of human gait. University of Waterloo Press, Waterloo Wittle M (1991) Gait analysis: an introduction. ButterworthHeinemann, Oxford Yigiter K, Sener G, Erbahceci F, BayarK, Ülger ÖG, Akodog-an S (2002) A comparison of traditional prosthetic training versus PNF resistive gait training with trans-femoral amputees. Prosthet Orthot Int (26): 213-217

Gait

Götz-Neumann K (2003) Gehen verstehen, Ganganalyse in der physiotherapie. Thieme Verlag, Stuttgart Horst R (2005) Motorisches Strategietraining und PNF. Thieme

Verlag, Stuttgart Inman VT, Ralston HJ, Todd F (1981) Human walking. Williams and Wilkins, Baltimore

Fire Up Your Core

Fire Up Your Core

If you weaken the center of any freestanding structure it becomes unstable. Eventually, everyday wear-and-tear takes its toll, causing the structure to buckle under pressure. This is exactly what happens when the core muscles are weak – it compromises your body’s ability to support the frame properly. In recent years, there has been a lot of buzz about the importance of a strong core – and there is a valid reason for this. The core is where all of the powerful movements in the body originate – so it can essentially be thought of as your “center of power.”

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