Gait Training Health Article

Aftercare

Aftercare for gait training includes helping patients cope with the various disadvantages of assistive devices. Crutches and walkers, for example, are difficult to use in small or crowded areas. In addition, walkers offer little or no protection from backward falls. The use of axillary crutches may place too much pressure on the patient's underarm area. Quad canes are hard to use on stairs and may be unstable on some surfaces, since the patient must have all four cane legs down on the floor or pavement with hand pressure centered over the legs.

Results

The results of gait training vary according to the cause of the patient's gait abnormalities, his or her overall health and mental attitude, and the prognosis. Some patients may be able to walk again without assistive devices, while others may make only limited progress. The importance of encouraging physical activity, however, cannot be overemphasized. Even modest amounts of exercise help to prevent muscle atrophy, benefit the cardiovascular system, and may lessen the pain of osteoarthritis. In addition, most gait training patients find that a greater degree of physical independence is good for their spirits as well as their bodies.

Health care team roles

In addition to the roles of physicians and rehabilitation specialists in patient assessment and gait training, nurses and other allied health professionals should monitor the walking patterns of their patients and any use or misuse of assistive devices. Gerontologists should routinely assess elderly patients for changes in gait velocity, cadence, step length, or other indications of fears of falling. Furthermore, nurses and other allied health professionals should monitor all patients for changes in ambulation in an effort to maximize their safety.

BOOKS

Bennett, S.E., and J.L. Karnes. Neurological Disabilities, Assessment and Treatment. Philadelphia: Lippincott, 1998.

"Gait Disorders." Chapter 21 in The Merck Manual of Geriatrics, 3rd ed. Whitehouse Station, NJ: Merck Research Laboratories, 1995.

Hertling, D., and R.M. Kessler. Management of Common Musculoskeletal Disorders. Baltimore, MD: Lippincott, Williams & Wilkins, 1996.

Lehmkuhl, L.D., and L. K. Smith. Brunnstrom's Clinical Kinesiology. Philadelphia: F.A. Davis Co., 1996.

Magee, D. J. Orthopedic Physical Assessment. Philadelphia: W.B. Saunders Co., 1997.

Norkin, C.C., and P.K. Levangie. Joint Structure and Function: A Comprehensive Analysis. Philadelphia: F.A. Davis Co., 1992.

Perry, J. Gait Analysis: Normal and Pathological Function. Thorofare, NJ: SLACK Inc., 1992.

Pierson, F.M. Principles and Techniques of Patient Care. Philadelphia: W.B. Saunders Co., 1999.

ORGANIZATIONS

National Rehabilitation Information Center and ABLEDATA (database). 8455 Colesville Road, Suite 935, Silver Spring, MD 20910. (800) 346-2742 or (800) 227-0216.

Mark Damian Rossi, Ph.D., P.T.