You just spent the last 4 weeks working with your physical therapist on exercises to strengthen your core and legs, all the while focused on improving your balance. Learning to walk again requires a foundation of good biomechanics that began with physical therapy, separating each piece of walking into small exercises.
The end goal of gait training is to help you progress from using a walker for two-handed support to either a quad cane or fully independent walking, and it all begins by learning how to take one step at a time. In this article we'll discuss a few gait training exercises that prepare you for walking with your above or below-knee prosthesis.
You may perform this exercise at any stage during your rehabilitation program. The goal is to encourage side-to-side weight shifting and strengthen your abductor (outer leg) muscles. These muscles are responsible for moving your leg away from your body's midline.
Backward walking may be more challenging for above-knee amputees than below-knee amputees because of the lack of knee flexion in the prosthetic limb. However, above-knee amputees can learn to execute this move with practice.
This exercise helps improve balance and prosthetic control. You can expect a similar activity in your rehabilitation program as changes in direction can be challenging for new users. However, practicing this move helps improve your mobility when dealing with more challenging real life scenarios, such as crowded spaces.
Often changes in direction will prove difficult for amputees, and practice will help improve mobility in more challenging environments such as crowded public spaces.
To perform this movement, it might help you to lead with your sound side leg to encourage proper weight-bearing on your prosthetic limb.
Besides weight-bearing and gait training exercises, your rehabilitation program should help you do functional tasks to ease your daily life challenges. But before crafting your plan for functional tasks, your healthcare team will consult with you on your goals. Below are some exercises you can expect to do.
Stairs and ramps
You will always encounter obstacles in daily life, such as the stairs at home or ramps. Since walking on stairs and ramps is part of your everyday life, your gait re-training will help you practice walking on such surfaces. One trick that you can do is to lead with your sound side leg when you ascend the stairs and lead with your prosthetic leg first when descending.
As for dealing with ramps or slopes, expect to shorten your stride length. Some prosthetic users find it easier to ascend and descend slopes through sidestepping (see above). You may use the same stepping techniques you use for stairs.
You can also expect to practice walking on uneven surfaces during your gait training program. This is because walking on various surfaces improves awareness and proprioception, which refers to your body's ability to perceive its position in space. This exercise also trains you to use your sense of sight to compensate for the reduced proprioception on your prosthetic side.
As you go through your gait training, always remember that slow progress is okay. Your body is working hard to relearn and reprogram itself on how to move, and it's going to take some time. Aim for consistency and safety, and you will eventually achieve your goals.