Gait Training Archives - Damien Howell PT

Walk this way – Run this way

What way should we walk? What way should we run? Mel Brooks and Gene Wilder wrote the script for the movie “Young Frankenstein” in which the character Igor the hunchback shows Dr. Frankenstein “this way”, and hands him his cane, expecting Dr. Frankenstein to mimic his hunched, contorted shuffle, which Dr. Frankenstein cordially does. This…

How 2D video motion analysis facilitates problem solving, reflective learning, & identification of novel interventions

The referral of this gentleman in the video below was for an exercise program for chronic right knee pain. The patient and the referring Physician Assistant expressed expectations that an exercise program would help decrease his pain so he could return to playing recreational basketball. There is ongoing controversy about whether high-intensity quadriceps strengthening exercises…

Sensory preference & learning optimal movement

There are many cognitive strategies to cue, prompt, and provide feedback to improve movement. Theory of focus of attention The dominant theory proposed by Gabriele Wulf and colleagues is providing cueing, prompting, or feedback to facilitate learning to move in a more optimal way is using an external focus of attention is more effective and…

Catch 22 – Underutilization of 2D Slow-Motion Video Analysis

Why is there low utilization of 2D slow motion video analysis of movement by Physical Therapists? There are many advantages for using 2D slow-motion video analysis for management of movement disorders including increased accuracy of diagnosing movement impairments; improved communication with patients and healthcare team; increased engagement of the patient; and improved understanding of movement…

Optimizing human movement requires clarity of description of movement

To know where you are going you must first know where you are. To optimize human movement, analysis of human movement is required. To identify optimal human movement clear qualitative and quantitative descriptions are needed. When describing human movement confusion occurs when we fail to clearly identify a frame of reference and reference point. A…

Whole vs part method of learning to walk/run a new way: deviant to less deviant

When learning a new physical skill an individual, therapist, or coach can choose to practice a new skill in whole or part. Motor skills learning can be practicing the whole movement or part of the movement. In whole practice acquiring a skill is by practicing the movement in its entirety, whereas the part that practices…

Better cues & mental practice to improve skillful movements: Are external focus cues better than internal focus cues? It depends

Coaches, athletes, healthcare professionals, verbal cues, use mantras, self-talk, visual imagery, and skill training to improve movement. There are many cognitive strategies commonly used to improve human movement to move faster, farther, injury-free, and/or just look better moving. Types of cues: A substantial amount of research in the area of motor learning examines different types…

Gait Deviations Musculoskeletal Pain Syndromes: Is there a gait deviation or cluster of gait deviations which is common across musculoskeletal pain syndromes?

Gait deviations are considered risk factors and/or causative drivers for musculoskeletal pain syndromes. There is a growing body of research showing a relationship between gait deviations and musculoskeletal pain syndromes injuries: shin pain (here, & here,) ; patella-femoral arthralgia (here); IT band syndrome; Achilles pain; plantar heel pain (here, & here). There is growing consensus…

Low-Tech Slow-Motion Analysis – “Dance Step to Nowhere

NDeviant movement during walking contributes to the development of or compensation for musculoskeletal pain syndromes. Diagnosis and treatment occur with visual observation and analysis of gait. The use of a smartphone video facilitates the analysis of motion walking. However, there are times when less technological motion analysis is necessary. When dealing with painful musculoskeletal syndromes…

Symptom modification of painful gait

Symptom modification procedure is common practice in the Physical Therapy profession. This procedure involves identifying the specific movement, posture, and/or activity that reproduces the patient’s symptoms. Historically diagnosis of musculoskeletal problems was based on examination which selectively provoked musculoskeletal tissues by compressing or stretching the various tissues to provoke the symptoms. This provided direction for…