How to Increase Mobility with Gait Training

The loss of a limb changes how your body moves. Gait training is an integral part of gaining and maintaining mobility through muscle strength, balance, and correct movement patterns. Even if it’s been a while since you’ve done gait training, keeping your muscles strong and balanced can prevent changes in your movement patterns, preventing pain throughout your body. 

We spoke with physical therapist Cosi Belloso, who focuses her practice on working with individuals with limb loss. She provided insight into the bigger picture of maintaining a healthy gait as well as insight into some of the exercises to get you started. 

What is gait training? 

When we talk about gait, we’re talking about the movement pattern used for walking. Walking is a far more complex action than most people realize. While you walk, the body has to:

• Balance on one leg
• Lift a foot to clear the ground 
• Absorb shock
• Maintain momentum
• Shift weight
• Flex and extend the hips and ankles

There are numerous ways you can compensate for lack of strength, poor balance, and inflexibility. Pinpointing your specific areas of weakness isn’t something you can do on your own. 

If you’ve been sedentary because of injury or just a lack of activity, Belloso suggests a visit to a physical therapist “A PT will analyze your range of motion, potential muscle imbalances, as well as analyze your gait,” Belloso says. “It could even be a problem with the fit of your socket.” A PT will look at five areas where you could need help with:

1. Range of motion
2. Flexibility
3. Balance
4. Strength (including core strength)
5. Gait

Other areas that the PT will take into account include proprioception, awareness of where your body is in relation to your surroundings, and cardiovascular fitness. 

Gait Training Exercises You Can Do at Home

We highly suggest a visit with your PT before you do any intensive gait training. However, the following simple exercises can strengthen your body on your way to healthy movement patterns. They can be done in your living room and be incorporated into your regular exercise routine.

Before starting an exercise routine, take care of your skin. Dry, cracked skin easily gets irritated or infected, which can keep you out of your prosthesis and your favorite activity. Keep your residual skin clean and moisturized. If you’re prone to chafing, try VitalFit’s Liquid to Powder Plus to create a friction barrier between your skin and socket.

Knee to Chest (or Seated March)

• Sit in a chair and pull your belly button toward your spine.
• Keep your trunk upright while lifting your right knee toward your chest.
• Lift your knee slightly and slowly return it to the starting position. (Gradually, raise your knee higher as you develop more strength.)
• Repeat with the left knee. 

Do ten repetitions with each leg. Try to prevent your upper body from swaying. 

This exercise should look and feel like marching in a seated position. It strengthens the core (abs), hip flexors, and quads. 

Stand/Sit

Moving from a sitting to a standing position and back again requires a great deal of muscle strength, coordination, and effort. 

• Start in a seat position. 
• Begin to stand, but be sure to evenly distribute your weight between your leg and prosthesis. 
• Come to a standing position.
• Slowly sit back down, again, with your body weight evenly distributed on both legs and feet. 

Use a table or the arms of the chair to maintain your balance. This exercise develops balance and muscle strength through the core, lower back, hamstrings, and quads.

 

Bridge

This exercise activates and strengthens the glutes. (Check out Cosi’s instruction video for the bridge under Featured Exercises.)

• Lie on the floor with your feet underneath your knees. 
• Tighten your glutes, lifting your hips to create a straight line from your knees to your shoulders. 
• Hold for a count of ten, and lower your hips to the floor. 
• Repeat for nine more repetitions.

Make sure to lift equally on both sides of the body. The glutes are a weak point for most people because of all the time spent sitting at a desk or on a couch. 

You can make this exercise harder by straightening one leg and using the other leg to lift your hips. Perform this exercise on both sides to keep the muscles balanced. 

Donkey Kicks

• Get on the floor on your hands and knees. 
• Keep your knee at a 90-degree angle while lifting your left leg until your thigh is in a straight line with your body. 
• Repeat for nine more repetitions with the left leg. 
• Repeat with the right leg. 

This exercise works and activates the glutes and other hip extensor muscles.

One Leg Stand

• Stand with your weight evenly distributed between both feet. 
• Slowly lift your left foot, hovering it just above the floor. 
• Hold for a count of ten before lowering the foot. 
• Repeat with the right foot. 

There are many ways to modify this exercise. If your balance needs work, do this exercise next to a chair or counter as a safety precaution. The higher you lift your foot/knee, the more difficult it is to balance. You can also make it harder by extending the amount of time you balance on one foot.  

 

The Takeaway

Muscle imbalances can sneak into your life without you noticing. An injury or extended period of inactivity (like winter settling in) can cause muscles to weaken. When you start moving again, the resulting changes to your movement patterns could keep you from being as active as you’d like to be. Once you do, gait training exercises are simple to add to your regular workout routine and will help get you back to your active lifestyle. Talk to a PT or doctor for more in-depth help with your individual movement issues.