Post by Lαrα on Apr 29, 2014 0:35:33 GMT -8
When Spinal Cord Injury is 'incomplete' there may be potential to be able to walk. Gait training will help facilitate this. Some individuals even if they are complete may still receive gait training...it depends on the individual and their physio team.
Incomplete injury and having the the muscle power needed will depend on how much signal remains to the muscles below injury level, It varies so much for each person.
Dependent on which nerves are damaged from the spinal cord that lead to muscles below injury...and the extent of damage will vary so much. Some muscles may have some signal and some may have none so weakness and muscle power can vary.
Altered sensation can also affect walking and also spasticity, pain levels and fitness.
When i first started to walk i had little confidence..i felt certain that i would fall. The first steps i took were very awkward and with a walker. I actually could not remember how to walk. I had a physiotherapist with me who was showing me how to strike off with my feet and was talking me through how to walk correctly.
I used my chair and walker for some time but then progressed onto crutches after some time...this was scarey lol I felt certain the i would fall forward.
Again it felt very different than using a walker.i had to build up my confidence again.
Gait training involves practice walking with support/assistance.This can be using in the form of using AFOS.... , walkers, crutches...parallel bars..etc
The following categories are used by health professionals to describe the kind of walking you are able to do:
Community: You are able to walk at home and in the community.
Household: You can walk within the home and use a wheelchair as the primary way to get around in the community.
Exercise: You use a wheelchair in the community and at home, and you walk with assistance once or twice a day for exercise.
Non-ambulatory: You only use a wheelchair for mobility.
How to determine if gait training is right for you
A physical therapist (PT) or other clinician will determine if gait training is right for you by using a variety of tests.
He/she will test your strength, sensation, ability to stand up, balance while standing, spasticity or stiffness, and range of motion at your hips, knees, ankles, and trunk.
If you are able to take some steps, the clinician will watch you walk to look for safety issues.
The clinician may also provide assistive devices and/or braces to give you better balance, protect your joints, and ensure your safety as you walk.
He/she may then test your walking speed, endurance, and balance with these devices and braces to keep track of your therapy progress.
Gait training may not be appropriate for you if:
You are too weak to support your body weight over ground.
Your blood pressure is unstable.
You have fractures or risks for fractures.
You have a high risk falling and hurting yourself.
You are unlikely to become independent with walking.
Gait training treatment options
Early Gait Training - Beginner level
If gait training is right for you, it is best to be upright and moving as soon as possible. You may take your first steps after the SCI using a variety of equipment including parallel bars, a walker and braces, a pool, or a body-weight support device.
A body-weight support device lifts part of your weight through a harness you wear as you try to take some steps.
Some of these devices roll on the ground and some are placed over a treadmill. Your therapist, a therapy team, or a robotic-device may help with your balance and stepping movements.
Later Gait Training - More advanced level
Depending on your SCI, your therapist may begin to work with you on the ground without a body-weight support device or parallel bars. You may also be given assistive devices and/or braces to improve your balance and help you walk safely.
The specific device you need will depend on your strength and balance. It is helpful to experiment with different assistive devices and braces to find what is right for you.
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