Gait trainer
Encyclopedia
A gait trainer is a wheeled device that assists
a person who is unable to walk independently to learn or relearn to walk safely and efficiently as part of gait training
. Gait trainers are intended for children or adults with physical disabilities, to provide the opportunity to improve walking
ability. A gait trainer offers both unweighting support and postural alignment to enable gait practice. It functions as a support walker and provides more assistance for balance and weight-bearing, than does a traditional rollator walker, or a walker with platform attachments. It also provides opportunities to stand and to bear weight in a safe, supported position.
Various movement disorders can result in the inability to walk independently, necessitating the use of a gait trainer. Such motor disability may be due to a medical condition from childhood, such as cerebral palsy
, spina bifida
, or other developmental disabilities. Or, walking impairment may be due to a later injury or illness, such as a traumatic brain injury
, incomplete spinal cord injury
or stroke
. Regardless of the cause of disability
, the child or adult may learn to walk, or recover the ability to walk, through walking practice. Recent discoveries in the field of neuroplasticity
indicate the human potential for improvement in motor skills through activity-based therapy, despite neural damage from condition or injury. Although total independence in gait may not be achieved in every case, significant gains can be made in muscle strength and neuromotor control for walking, through locomotor training.
sessions. The more recent development of body-weight support gait training, such as over a treadmill, can enable considerably more walking practice with less strain to the therapist, when compared to traditional gait training.
In adult rehabilitation, the use of body-weight support (BWS) systems enables patients to walk safely with less effort. Body-weight support systems enable walking practice over a treadmill. Or, they may enable walking over ground from a mobile device or ceiling track. Because of the support provided by the system, the strain to the therapist is reduced. This, along with the patient being adequately supported for balance and weight bearing assist, increases the duration of walking practice. This effective therapy increases potential for motor skill gains. The more opportunity for practice and repetitions of step-taking, the more likely is the patient to regain walking ability.
The use of over ground support walkers as an approach for gait training for the adult population is another recent development in adult rehabilitation. The value of over ground gait trainers is that these devices are typically more affordable than BWS systems, and they enable additional walking practice beyond the physical therapy session, whether in the institution or in the patient’s home or community environment. By using a gait trainer for over ground walking practice, the patient has support for balance and can now incorporate walking practice into his or her daily routine. For example, rather than remaining in a wheelchair between gait therapy sessions, an individual can use the over ground gait trainer for walking practice to and from the cafeteria within an institution, or while at a mall when out in the community.
Early research indicates that sufficient over ground locomotor training may result in equivalent or possibly greater improvements in walking capacity as compared to the body-weight support treadmill training. The over ground walking practice is a closer replication to the real-world task of walking. The voluntary effort of step initiation and forward progression is essential for walking over ground, and these devices enable the patient to learn how to generate and control these motor forces in a way that is not available on a treadmill.
Assistive technology
Assistive technology or adaptive technology is an umbrella term that includes assistive, adaptive, and rehabilitative devices for people with disabilities and also includes the process used in selecting, locating, and using them...
a person who is unable to walk independently to learn or relearn to walk safely and efficiently as part of gait training
Gait training
In its most general form, Gait training is the act of learning how to walk. However, the term is more often used in reference to a person learning how to walk again after injury or with a disability...
. Gait trainers are intended for children or adults with physical disabilities, to provide the opportunity to improve walking
Walking
Walking is one of the main gaits of locomotion among legged animals, and is typically slower than running and other gaits. Walking is defined by an 'inverted pendulum' gait in which the body vaults over the stiff limb or limbs with each step...
ability. A gait trainer offers both unweighting support and postural alignment to enable gait practice. It functions as a support walker and provides more assistance for balance and weight-bearing, than does a traditional rollator walker, or a walker with platform attachments. It also provides opportunities to stand and to bear weight in a safe, supported position.
Various movement disorders can result in the inability to walk independently, necessitating the use of a gait trainer. Such motor disability may be due to a medical condition from childhood, such as cerebral palsy
Cerebral palsy
Cerebral palsy is an umbrella term encompassing a group of non-progressive, non-contagious motor conditions that cause physical disability in human development, chiefly in the various areas of body movement....
, spina bifida
Spina bifida
Spina bifida is a developmental congenital disorder caused by the incomplete closing of the embryonic neural tube. Some vertebrae overlying the spinal cord are not fully formed and remain unfused and open. If the opening is large enough, this allows a portion of the spinal cord to protrude through...
, or other developmental disabilities. Or, walking impairment may be due to a later injury or illness, such as a traumatic brain injury
Traumatic brain injury
Traumatic brain injury , also known as intracranial injury, occurs when an external force traumatically injures the brain. TBI can be classified based on severity, mechanism , or other features...
, incomplete spinal cord injury
Spinal cord injury
A spinal cord injury refers to any injury to the spinal cord that is caused by trauma instead of disease. Depending on where the spinal cord and nerve roots are damaged, the symptoms can vary widely, from pain to paralysis to incontinence...
or stroke
Stroke
A stroke, previously known medically as a cerebrovascular accident , is the rapidly developing loss of brain function due to disturbance in the blood supply to the brain. This can be due to ischemia caused by blockage , or a hemorrhage...
. Regardless of the cause of disability
Disability
A disability may be physical, cognitive, mental, sensory, emotional, developmental or some combination of these.Many people would rather be referred to as a person with a disability instead of handicapped...
, the child or adult may learn to walk, or recover the ability to walk, through walking practice. Recent discoveries in the field of neuroplasticity
Neuroplasticity
Neuroplasticity is a non-specific neuroscience term referring to the ability of the brain and nervous system in all species to change structurally and functionally as a result of input from the environment. Plasticity occurs on a variety of levels, ranging from cellular changes involved in...
indicate the human potential for improvement in motor skills through activity-based therapy, despite neural damage from condition or injury. Although total independence in gait may not be achieved in every case, significant gains can be made in muscle strength and neuromotor control for walking, through locomotor training.
Pediatric Use of Gait Trainers
One of the first gait trainers for use by children with developmental disabilities was developed in the mid 1980’s for use with the MOVE Curriculum, by a special education teacher in California, Linda Bidabe, in collaboration with others at the Blair Learning Center. Since that time, pediatric gait trainer design has evolved and been refined, and several manufacturers have developed quality gait trainers.Use of Gait Trainers for Adult Rehabilitation
In adult rehabilitation, gait training is traditionally performed initially within parallel bars as the most stable assistive device. As walking improves, a patient can progress to a walker, crutches, bilateral canes or a single cane. This gait training typically occurs during physical therapyPhysical therapy
Physical therapy , often abbreviated PT, is a health care profession. Physical therapy is concerned with identifying and maximizing quality of life and movement potential within the spheres of promotion, prevention, diagnosis, treatment/intervention,and rehabilitation...
sessions. The more recent development of body-weight support gait training, such as over a treadmill, can enable considerably more walking practice with less strain to the therapist, when compared to traditional gait training.
In adult rehabilitation, the use of body-weight support (BWS) systems enables patients to walk safely with less effort. Body-weight support systems enable walking practice over a treadmill. Or, they may enable walking over ground from a mobile device or ceiling track. Because of the support provided by the system, the strain to the therapist is reduced. This, along with the patient being adequately supported for balance and weight bearing assist, increases the duration of walking practice. This effective therapy increases potential for motor skill gains. The more opportunity for practice and repetitions of step-taking, the more likely is the patient to regain walking ability.
The use of over ground support walkers as an approach for gait training for the adult population is another recent development in adult rehabilitation. The value of over ground gait trainers is that these devices are typically more affordable than BWS systems, and they enable additional walking practice beyond the physical therapy session, whether in the institution or in the patient’s home or community environment. By using a gait trainer for over ground walking practice, the patient has support for balance and can now incorporate walking practice into his or her daily routine. For example, rather than remaining in a wheelchair between gait therapy sessions, an individual can use the over ground gait trainer for walking practice to and from the cafeteria within an institution, or while at a mall when out in the community.
Early research indicates that sufficient over ground locomotor training may result in equivalent or possibly greater improvements in walking capacity as compared to the body-weight support treadmill training. The over ground walking practice is a closer replication to the real-world task of walking. The voluntary effort of step initiation and forward progression is essential for walking over ground, and these devices enable the patient to learn how to generate and control these motor forces in a way that is not available on a treadmill.