Your gait refers to your manner of walking, and gait training refers to the process of improving your ability to walk.
Some people require gait training after a physical injury like breaking a bone. But this article will focus specifically on gait rehabilitation after a neurological injury like stroke.
Gait training for stroke patients take a slightly different approach, which you’re about to learn. Then we’ll provide some exercises and rehab methods to help you get back on your feet.
Gait Training: Improving Your Ability to Walk
When a stroke affects your gait, the brain has difficulty sending the correct signals to your leg muscles. This makes it difficult to move, and thus impairs your ability to walk.
As a result, stroke patients may struggle with the following mechanisms required for proper gait:
- Limited dorsiflexion (the ability to lift the front part of your foot up towards your shin)
- Lack of knee flexion and extension (bending and straightening your leg)
- Limited hip extension (the ability to bend your thigh at the hip)
To help with these problems, your physical therapist will guide you through various gait training exercises.
The goal of these exercises is to help spark neuroplasticity and rewire the brain. That way, your brain can improve sending the correct signals to your legs.
Some other goals of gait training include:
- Increasing muscle strength and coordination in the legs
- Retraining voluntary response in the lower muscle groups
- Increasing flexibility, cardiovascular fitness, and balance
The best way to get there is with gait training exercises.
9 Gait Training Exercises for Stroke Patients
Effective gait training exercises should target the legs, of course, but that’s not all. Walking is a full-body task that requires coordination from your feet and core also.
The following gait training exercises target all of these muscles groups to help improve your balance and coordination while walking. The photos feature therapists Liliana, DPT, and Cassie, DPT.
Here are some excellent gait training exercises that can help improve your ability to walk:
1. Seated Marching
This basic gait training exercise can be done from any seated position.
Start by lifting your affected leg up into your chest, and then place it back down onto the floor. Then repeat on the other leg, alternating back and forth.
Be mindful of keeping your back straight and maintaining controlled movement.
To add some challenge, pause at the top for a second or two. The quickest way to build a muscle is to hold the pose for a few seconds.
2. Knee Extension
Knee extensions are a preliminary gait training exercise because your knees are constantly bending while you walk.
To perform this exercise, start from a seated position. Extend your leg out in front of you parallel to the floor. Try to avoid locking your knee completely and keep a soft bend.
Then, slowly bring your foot back down to the floor. Alternate back and forth between your right and left leg.
Watch Liliana, DPT, demonstrate more leg exercises for stroke patients in this video:
Now let’s move onto some balance and core exercises.
3. Toe Taps
Building a strong core is essential for improving your gait. This exercise targets all the muscles in your core.
While lying on your back, lift your legs up and bend your knees at a 90 degree angle. Your shins should be parallel to the floor and your core should be fully engaged.
From there, bring your left leg down and gently tap the floor with your left foot. Then, bring your leg back up.
Focus on tightening your core while performing the movements in your legs. Maintain a 90 degree bend in your knee the entire time.
Repeat on the other leg and alternate between each leg.
4. Knee to Chest
For this gait training exercise, start from a comfortable lying position. Then hug your knees into your chest. Hold onto your left leg with your left arm and then extend your right leg onto the floor.
Then bring you right leg back into your chest. Try not to use your leg muscles to achieve this movement. Focus specifically on engaging and tightening your core.
Repeat by alternating with each leg.
5. Flamingo Stands
For this simple gait training exercise, stand like a flamingo. Meaning, practice standing on one leg for about 30 seconds and then switch to the other foot.
Hold onto a chair, counter top, or table for safety and stability. When you’re ready for a challenge, don’t hold onto anything – but make sure you’re not at risk of falling.
6. Side Leg Raises
For this gait training exercise, start from a standing position. Then, lift your leg out to your side about 45 degrees (or as far as you can). Hold it there for a few seconds and then bring your foot back down. Alternate between each leg.
Watch Cassie, DPT, demonstrate more core exercises for stroke patients in this video:
Now let’s move onto some foot exercises.
7. Ankle Dorsiflexion
This gait training exercise will help target your feet and improve conditions like foot drop after stroke.
To begin, start from a seated position and cross your affected leg over you other leg.
Then, move your foot into dorsiflexion (image 1) by using your unaffected hand to move your foot up towards your knee.
Next, move into plantar flexion (image 2) by extending your foot back down.
For added challenge, complete these exercise without the use of your hand. (That would turn this into an active exercise instead of a passive exercise.)
8. Assisted Toe Raises
This gait training exercise can be difficult if you have foot drop. However, it can help improve foot drop by retraining the brain to send the correct signals to your foot.
Start from a seated position. Then place your unaffected foot underneath your affected foot. Then, use your foot to assist your affected foot up. Then release back down.
Once you regain the ability to perform these without assistance, do active exercise for added challenge.
9. Heel Raises
This is an advanced gait training exercise. Start with your feet flat on the ground. Then, point your toes and lift your heels off the ground. Then place your feet back down flat on the floor and repeat.
While this concludes our list of gait training exercises, your recovery doesn’t have to stop here! There are plenty of other ways to boost your results and get back on your feet faster.
Other Methods of Gait Rehabilitation
Gait training exercises are just one way to improve your gait and walking abilities after a stroke.
Here are other excellent gait rehabilitation methods:
- Strength training. Some muscle atrophy is common after a stroke. Therefore, adding some strength training can help improve overall health and gait. Keep in mind that this addresses the secondary complication of muscle atrophy, while rehab exercise addresses the primary concern.
- Balance and core training. Balance and core training both help improve gait. Walking is a full-body task that requires coordinated movement from the feet, legs, and core.
- Task-specific training. This simply refers to walking. If you have the ability to safely walk (with or without a walker/cane), then you should walk as often as you can. This will help improve your gait. People going to inpatient rehab should take advantage of gravity-assisted treadmills to get even better task-specific training.
- Functional electrical stimulation. Adding electrical stimulation to the affected muscles during gait training exercises can help boost results, according to studies. Be sure to work with a physical therapist to learn where to place the electrode pads as it will differ for everyone.
- High-tech home exercise equipment. Improving your ability to walk requires a high repetition of gait training exercises. More repetition helps stimulate the brain and boost neuroplasticity. High-tech exercise equipment like Flint Rehab’s FitMi can help. Many patients have gotten back to walking and driving (i.e. targeting the gas pedal) by using FitMi consistently.
It often works best to approach gait training with multiple rehabilitation methods. Try combining gait training exercises with any of these methods above.
As always, be sure to consult with your physical or occupation therapist first before making changes to your rehabilitation program.
Benefits of Gait Training After Stroke
Gait training exercises can help prevent falling after stroke, because strong legs provide stabilization if you lose balance.
Ultimately, a consistent rehab exercise program can help you get you back onto your feet and back to the activities that you enjoy.
Focus on high repetition of exercises to help rewire the brain. Be sure to target your core and feet along with your legs to improve overall coordination and balance.
You can add booster techniques, like electrical stimulation and FitMi home therapy, for even faster results.
By using these methods, you can relearn how to walk and reclaim your independence after stroke.