Reasons to Visit

Learn more about some of the conditions we treat

Gait (Re)Training

The way that we walk, also known as our gait cycle, can have a tremendous impact on the quality of our lives. Those that experience pain while walking can often find relief by having their gait assessed. The use of dual camera slow-motion video and in-shoe sensors is a technology that can provide valuable information on the symmetry, timing and movement patterns throughout the gait cycle. A podiatrist will then be able to suggest solutions that will reduce pain and disability, and allow you to participate in meaningful activity again.

Introduction

When dopamine production in the substantia nigra decreases, Parkinson’s disease develops. Parkinson’s disease is an increasingly debilitating neurodegenerative movement disorder. Rigidity and tremor are two of the most prominent symptoms of this condition. Falls and fractures are more common in this group of patients because of their lower level of balance and postural stability. Parkinson’s patients shift their weight differently than healthy age-matched controls in response to a backward waist pull, using a modified ankle joint motion before lift-off and landing with weight shifted posteriorly.

Parkinson’s disease-related gait pattern

  • There is a condition known as hypokinesia (decreased step length with decreased speed)
  • Coordination has been reduced.
  • Punishment for Delayed Action (decreased step length with increased cadence)
  • Gait immobility (the inability to produce effective steps at the initiation of gait or the complete cessation of stepping during gait)
  • Inability to perform two tasks at once while walking

Anatomy of the Stance

Gait kinematics changes include hip and ankle joint excursion changes. Toe to heel or flat foot progression may be more common in patients with the disease. The Parkinson’s patient appears to have lost the adult gait pattern and is now using a more primitive walking pattern. It is difficult to step over obstacles or walk on carpeted surfaces when one has flat feet. Three-dimensional gait analysis has revealed a decrease in terminal stance plantar flexion.

Physiology of disease

Reduced equilibrium responses may contribute to festinating gait, according to one theory. An individual may completely fall or continue to take short running-like steps if walking is a series of controlled falls and if the individual’s normal responses to falling are delayed or not strong enough. Bradykinesia, characterized by abnormal motor unit firing, may also be the source of the patient’s shortening steps.

Exercising Your Flexibility

Reuter et al. found that flexibility exercises and relaxation training improved performance in the 12 m and 24 m Webster Walking tests. The training was conducted three times a week for six months to improve flexibility, balance, and range of motion. However, there was a more significant gain in the walking group and the Nordic walking group. This suggests a more focused approach to getting the job done well.

Training for Strength

However, there is evidence that progressive resistance exercise can be beneficial and worthwhile in people with mild to moderate Parkinson’s. Still, the benefits do not carry over to all physical performance measures. Progressive resistance training should be used in Parkinson’s rehabilitation, especially when the goal is to increase walking capacity.

Training on a treadmill

Earhart and Williams reviewed the literature to determine whether or not treadmill training could improve the gait of people with Parkinson’s disease. The authors reviewed randomized control trials and randomized controlled crossover trials. This systematic review concluded that treadmill training is safe and appropriate for some people with mild to moderate Parkinson’s disease.

Gait Training for Multiple Tasks at Once

Having trouble multitasking (also known as “dual tasking”) is a common and debilitating symptom of Parkinson’s disease. People with Parkinson’s tend to walk more slowly or take shorter steps if asked to perform another task while walking. D’Souza et al. investigated whether treadmill training could improve Parkinson’s disease patients’ gait performance while doing two things at once.

You can select both clinics according to your preference.
You can select both clinics according to your preference.