"Gait" Therapy?

[Heather3418]

Does anyone know what is involved with "gait" training?  I will be going to a physical therapy center to have this done and wonder what it entails.  Probably should ask the center, but I knew I would get better answers from someone that knows about it or has been through it themselves.  

Physical therapy is very time consuming and to be honest, I don't want to waste my time and energy doing exercises that are really not going to make a difference in my course with MS and my walking.  My Neuro has ordered this to hopefully keep me off of a walker or cane.  She also said that the exercises will also help me with my balance.  I don't see how that is possible, since we cannot change the mixed "message signals" coming from the brain and spinal cord, when there is a damaged area causing the balance issues.

Thanks in advance for your input.

Big Hugs,
Heather  

[Quixotic1]

Oh, Heather, you have tears in my eyes!

I haven't read all the responses because my eyes are goofy, but when my neuro order "gait training" it was specific PT.  I had both regular PT and gait work.  My PT was brilliant and kept analyzing my gait, then she would work on specific muscle group stregnthening.  Finally, she began working on the mechanics of my gait, the rhythm and such.

My gait got better and better.  Then finally after I got my AFO she watched me walk around the room forever, it seemed.  then she made a little change in it.  She told me to "pop" my R knee - flex my R knee - earlier in the stride forward.

Voila'!  I could walk straight without swinging my leg out.  I slowed my gait to do it and had to practice it a  lot, but suddenly I could walk with a semi-normal gait.

If the PT is good at what they do, it can be wonderful!

I agree with what Sho wrote and the article which I have also read.  "Exercise training" can be an exercise in futility.  But, what that article describes is not guided strengthening.  Gait training - as it was practiced on me was guided strengthening of a couple specific muscle groups and then work on the actual "mechanics" of the gait.

And you are right.  We have the best members, the best forum ANYWHERE.  (I have looked at a lot of forums)

Quix

[Heather3418]

If you were sitting next to me, I would give you a hug so big, it would probably hurt.  The article you listed is EXACTLY the kind of article I have been trying to find on the net.  This is a very informative offer.  God Bless you sweetheart for bringing it to our attention.  

I am going to read it in depth right now.  Thank you again for finding this.  

BIG Hugzzzzzzzzzzzzzzzzz,
Heather

What a fantastic group we have here on this Forum.  We REALLY are a family.  None of us give up or give in, when we are trying to help others find information or give information about our personal experiences.  This is just one of the things that makes this Forum so successful.  All the members GET INVOLVED and are quick to help the other.  Everysingle one of you deserve a big bear hug from me, "Earth Mother."  Since I can't reach all of you personally, grab yourselves around the shoulders and SQUEEZE.  That's from me to you....  I am so thankful for the day that I joined this Forum over a year ago at the invitation of a brilliant, beautiful lady named, Quixotic1; lovingly known as Quizzle, Firzzle Quizzle, Momma Bear, etc....  Thanks Quixie girl and thanks to all of our members that keep this the greatest Forum on MedHelp...BAR NONE!

[doni54]

I can understand that with the fatigue you've been having lately the thoughts of PT has to be daunting.

I don't know anything about this type of PT, but I do know how the fatigue always plays a big part in any decision involving physical activity.

If you are physically able and decide to try this I pray that it will help. You know I'm always on your side, my friend.  I just hope you feel better soon.

Love & hugs
doni

[shoshin]

I did go to physical therapy to see if they could help me walk better. I was desperate and have pretty good insurance. I went for four weeks and since then I've been doing the exercises at home (well, most days).

I don't know that I did any gait training per se, but they gave me some exercises that were supposed to help with weakened muscles (hip flexors and ankles). This didn't have a huge effect so far as I can tell.

On the other hand, it turned out that they also gave me some exercises for balance, which I wasn't expecting. These were surprisingly effective. I definitely still have balance problems, but I rarely actually fall anymore.

Whether or not they can help you with balance I think depends on what's causing the balance problems. I had a test that measured the input from the different elements of the balance system. My vision is fine, my somatosensory input (sensations from the bottom of the feet) was somewhat low, but they said they couldn't do anything about that, and my vestibular system was about zero.

So they gave me exercises to try to challenge the signals to the vestibular system to re-route (basically standing in a corner with a chair in front of me and my eyes closed and moving my head different ways). I went from almost zero to around thirty on a 1-100 scale (where you only have to be around 55 to be normal for my age).

Here's a link to the abstract of a study I read about called "Effect of Exercise Training on Walking Mobility in Multiple Sclerosis: A Meta-Analysis":

http://www.ncbi.nlm.nih.gov/pubmed/18948413?ordinalpos=52&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum

Their conclusion basically was that "the cumulative evidence supports that exercise training is associated with a small improvement in walking mobility among individuals with multiple sclerosis" so I don't know that PT works any miracles.

I think I have read that changing some things with the form of your gait (like walking heel-to-toe instead of toe first) can help you walk better so maybe a physical therapist could spot something like that.

sho

[Sarahsmom46]

That's really encouraging feedback.  Thanks for sharing it.

[JulesL5S1]

I don't know what "gait training" is.  However, back in 2000 when recovering from my second back surgery (L5/S1 level) my neuro sent me to PT.  That neuro specialized in MS and strokes and sent me to the PT he used for those patients.  At the beginning the PT just used the exercises for people recovering from back surgeries.  There was only minimal improvement if any.  Finally in exasperation my PT went back and read the prescription (I should say that the PT asked me every time if there was another dx besides the back surgery).  The prescription was written broadly so the PT said she was scrapping the back exercises and starting another series.  (From my own research recently I know that she switched to exercises for people with MS.)  

For the first time in 8 months there was progress.  I did fantastic.  Those exercises made a HUGE difference in my life.  What we focused on was learning how much sensory input I had.  We tried things barefoot, in sock, in nylons, in dress shoes, in sneakers, etc.  We tried walking over different surfaces.  I had to describe what I felt.  We tried having me close my eyes, I immediately lost my balance.  We then focused on letting my eyes determine what my feet should feel.  My eyes then were able to keep me upright.  My eyes were able to have me walk on grass and pavement.  I learned that some of my shoes I could never wear again.  (I just couldn't get enough sensory input.)  We worked on how to walk on a sidewalk and then step down the curb.  

Bottom line, this therapy was excellent.  The only down side to the therapy is it may be hindering a dx (I'm in limbo land) because my problems aren't as extreme as others.  I credit the PT.  Working with a good/knowledgeable PT can do wonders.  Even if you have to drive it is worth it.  (The PT I went to in 2000 was not in an easy location for me to reach.  It was a struggle.  But once we started the new exercises and I improved it was worth it!)

I hope this helps.  cheers, Jules

[Sarahsmom46]

I try to live my life by the principle of "working smarter, not harder".  It works out sometimes.

And, like you guys have already said, if the "gait training" PT can help us find a more productive way to get the best use out of our muscles, then I'll hit the horse track and trot away with the rest of ya.

Julie
  

[Lulu54]

Heather and Julie,
It is certainly worth the call if not actually going and giving it a try.  You know the fatigue we experience from trying to move our legs daily and if there is something that can be done to lessen that fatigue I would be all for it.  Keep us posted on what you discover, ok?  Limping along today, Lulu

[Heather3418]

I too, went to "Google" it and could not find out any information.  That's why I came back to the Forum to ask our family.  Somebody on the Forum has had to go through this kind of therapy before, so that's why I am asking.

Please understand that I am not bitchin about having to do the therapy.  I will try ANYTHING that helps, but therapy is time consuming, very challenging at times (worse when you are fighting so many fatigue issues) and insurance balks at PT.  I'm lucky I really don't have to worry about the insurance issue. (YET)

I will do what I can to stay off a walker or cane.  I did have to use both in the first year after I was diagnosed, so been there and done that.  I am happy that I am not dependent on either right now and really feel for those that are or are in wheelchairs.  I have no right to be bitchin at all, do I?  If the gait therapy can help me avoid that, then I will be first in line.  

I think I'll do what Julie says and contact the therapy center to see what is involved, tomorrow.  There is power in knowledge.  Come on Julie, if I go, you have to give it a try too.  Okay?

Thanks ladies for your replies...

Big Huggie Wuggies,
Heather  

[Sarahsmom46]

After I saw your post I went and tried to Google "gait training" and nada.  There is nothing that talks about what types of things they do with you or exercises.  I keep passing by the script my neuro wrote at the last visit hanging on the fridge for "gait training" and am skeptical too. I was thinking about calling the PT center tomorrow to ask one of the therapists about what is involved with this type of PT and then decide if it is worth the time and money. I'll let you know.  

Julie

[Lulu54]

Good morning Heather,
You are absolutely right that PT takes a commitment of time and money.  My gait is deteriorating too and I'll be curious to see what our forum family can tell you about the PT's details.  I'm all in favor of anything that improves our quality of life but like you I'm skeptical.  Be well, Lu