Normal and Pathological Gait in the Elderly Peggy R. Trueblood, PhD, PT California State University, Fresno

Part III Gait Pattern Variation and Enhancement Training

FUNCTIONAL LEVEL TRAINING  Activities to challenge client to modify or adapt walking pattern to environment

Task Demands Environment Individual Capabilities Surface Type Visual Flow Seated Standing Moving Single Multiple Strength ROM Sensory Loss Cognition Lighting

GOAL is to maximize the challenge, minimizing the risk.

Consider activities that will challenge:  Timing demands  Spatial demands  Flexibility/Adaptability

Progression Variables  Change Environmental Demands Support Surface  Uneven  Compliant

Inclines Raised surfaces Moving surfaces

Narrow surface

Visual Environment  Head Turning  Focusing on object  Busy environment  Moving environment

Progression Variables  Change Task Base of Support

Gait Pattern  Crossover  Braiding  Side Step  Backwards

 Change Demand of Task Start/stop on command Directional changes on command Pacing of commands (faster pacing more demanding)

 Stepping over obstacles of various heights  Stepping around obstacles  Stepping on obstacles

 Increase Number of Tasks  Walking with head turns  Various obstacles to maneuver within an obstacle course

Carrying object while walking through obstacle course Add cognitive task