Gait Training Exercises for Lower-Limb Amputees
After limb loss, you may need to rest for a few weeks, which can lead to some tightness or weakness in your lower extremities. Your balance and proprioception will also be affected as you adjust to life with a prosthetic limb. When your condition is stable, and the physician clears you for physical therapy, your physical therapist can begin teaching you how to walk again.
What is gait training?
Physical therapists refer to walking as “gait.” The gait cycle includes:
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Lifting the foot
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Landing one foot on the floor
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Rolling over that foot
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Lifting it again
Gait training refers to a program consisting of exercises that can help you learn how to walk with your prosthetic leg. The exercises typically include improving range of motion, weight-bearing and balance, and strength. The goal of gait training is to help you walk safely, comfortably, and as normally as possible with your prosthetic limb.
Below are some of the most common gait training exercises prescribed to lower-limb amputees. However, your program may be different depending on your physical therapist’s assessment.
Gait training exercises
Range of motion exercises
After surgery, some joints and muscles may temporarily swell, and muscles may tighten due to a period of immobilization, limiting your range of motion. Exercises that work on your range of motion will help you regain and maintain a normal range of motion.
Hamstring stretches
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Sit on the edge of a sofa.
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Extend one leg out in front of you and keep the opposite leg to the side.
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Gradually lean forward until you feel resistance in the back of the extended leg.
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Repeat on the other leg.
You can do the exercise above on your own at least once a day, like when you get up in the morning. But don’t forget the other stretches indicated in your personalized program. Maintaining your range of motion is vital as it helps your joints move freely.
Weight-bearing exercises
The ability to carry your weight when using a prosthetic limb is crucial. Your physical therapist will help you execute this for the first few weeks. But you can also practice this at home.
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Using your walker, support your body using both hands.
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Shift your body weight from your sound side leg to the one with the prosthetic leg.
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Once you’ve mastered the above, switch to using one hand. Use the hand on the same side as your sound leg.
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After you’ve mastered weight-bearing with one hand, you can progress to fingertip support. Use the fingers on your sound leg side.
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The next step is to work on weight-bearing without using your hands for support. You can choose to do this exercise with your PT standing between parallel bars, so you have something to grab if things go wrong.
Photo courtesy of the International Committee of the Red Cross
Strengthening exercises
It's important to strengthen your ankles, hips, and knees—all of which are essential to walking. If these areas are weak, your physical therapist will include strengthening exercises in your program.
Below is a simple strengthening exercise you can do at home besides your exercise program.
Dorsiflexion and plantar flexion
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While seated on a stable surface, stretch your legs in front of you, then point your toes (plantar flexion).
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Bring your toes back and flex, so your toes are pointing towards the ceiling (dorsiflexion).
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Repeat on your other leg.
Stepping over obstacles with or without support
This exercise encourages you to mimic the actions you’re required to make when walking on a tricky surface. You can do this inside your walker for support or without support.
Obstacle gait training
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Set up a couple of obstacles, like exercise blocks or a small stack of books, in a row about 15 or 20 inches apart. When choosing your obstacles, select something like an exercise block or a small pile of books. Nothing too tall.
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Lift your foot and your knee over the obstacle.
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Repeat the same process with the other side.
Photo courtesy of the International Committee of the Red Cross
Balance and proprioception exercises
While walking, we spend some time balancing on one foot while the other swings through the air. This is why it’s crucial to work on your balance and proprioception during the rehabilitation phase.
A simple exercise that you can do at home when you’re not in physical therapy is the one-leg standing balance.
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Stand on one leg. You may hold on to a wall or desk if this is challenging.
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Hold this position for five to 10 seconds.
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Do the same on the other side.
Image courtesy of Prosthetic Running
You can also do the same exercise when working on your proprioception but with your eyes closed. Doing this exercise with your eyes closed will help you get a sense of your leg’s position in space without looking at it.
Gait training can help you get back to your activities safely and quickly. However, please remember to listen to your body and your physical therapist. Don’t push yourself if you feel tired or uncomfortable. Your body will heal on its own schedule.
