LEVEL 1 GAIT TRAINING EXERCISES FOR STROKE/ HEMIPLEGIA PATIENTS
LEVEL 1 GAIT TRAINING EXERCISES FOR STROKE/ HEMIPLEGIA PATIENTS
null
Content
9.46 -> Hello every one, you are watching physio classroom channel
12.3 -> and in this video of hemiplegia rehabilitation series
15.48 -> we are going to talk about how we can make a stroke patient walk normally through level wise gait training exercises
23.86 -> often it is seen that people are in hurry to make a stroke patient walk
30.22 -> stroke patient is still not able to stand properly
33.44 -> and two or three people often make patient walk with support
36.54 -> patient still has lot of fear of falling
39.5 -> and when the patient is made to walk prematurely like this
42.12 -> then the patient becomes too stiff from the paralyzed side
46.52 -> patient struggles in gaining control over the paralyzed side
49.78 -> and so the patient learns to walk in an abnormal manner
53.06 -> and often people start accepting stroke patient's abnormal walk as it is
57.36 -> although if proper gait training is done for stroke patients
61.32 -> then such patients can learn to walk in a near normal way
66.38 -> in this video we are going to discuss the Level 1 gait training exercises
70.94 -> and we will also share with you the right way to progress gait training exercises
77.7 -> so lets start today's video
80.22 -> in level 1 gait training, our focus will be on those exercises
85.98 -> in which patient's both feet (or a part of it) always in contact with the floor
93.86 -> such exercises are called as close kinematic exercises
98.32 -> close kinematic exercises allows the patient to develop good balance and stability
104.24 -> and through these exercises, the patient gradually learns how to develop better control over the knee joint
112.48 -> because it is very important to bend and straighten the knee to walk normally
119.5 -> so lets understand level 1 gait training exercises with 2-3 examples
126.62 -> to know better how to perform such exercises and what types of exercises should be performed in level 1 gait training
131.8 -> level 1 gait training exercises are also known as pre-ambulatory exercises
137.72 -> because the patient has to still learn how to walk and is exercising in standing position
141.64 -> level 1 gait training exercises will help the patient in gaining confidence that he will soon be able to walk without support
148.24 -> the fist exercise that we should teach our patient is
155.34 -> to learn how to control bilateral knee bending and straightening in standing position
162.5 -> therefore this exercise can also be called as bilateral knee bending and straightening exercise
167.72 -> so lets say if I am a left hemiplegia patient,
172.78 -> I have kept a support on my left side so that when I exercise my lower limb for gait training
180.92 -> I don't ignore my upper limb by ensuring that I keep pressing the support downward with my hand
187.1 -> Doing this will help the stroke patient to regain extensor control (ability to extend the elbow) of upperlimb
196.1 -> and patient will gradually find it easier to keep his elbow straight (instead of remaining abnormally flexed) while walking
201.54 -> so this must be ensured that the patient always presses down on a support using his hemiplegic hand
211.52 -> so in the first exercises the patient should try to bend and straighten both the knees together
219.76 -> we should choose different functional task while performing this exercise
223.82 -> like for example, we can keep some objects in front of the patient and can ask him to pick them up from below and keep them at a higher level
229.54 -> exercising like this will make the patient learn how to support and move the body on legs without loosing balance
238.84 -> and easily starts gaining control over knee movements
242.88 -> first exercise can be called as bilateral knee bending and straightening exercise
248.84 -> so as we can see that the patient's both feet will always remain in contact with the floor while doing this exercise
256.36 -> either of the foot will neither move on the floor nor leave the floor to move in air
265.32 -> the second exercise of level 1 gait training that we should teach the stroke patient is
270.12 -> alternate knee bending and straightening exercise
274.46 -> so after teaching bilateral knee bending and straightening, the patient should now learn to control one knee in extension while bending the other knee in controlled flexion
291.26 -> performing this exercises can be difficult for some stroke patients initially
296.24 -> but once with practice, when the patient masters this exercise, then the patient will also find it easier to walk in a normal way later on
303.02 -> because for walking it is important that when one knee bends the other knee should remain relatively straight and similarly when the other knee bends then the first knee should remain straight
313.96 -> therefore it is very important that patient masters this alternate knee bending and straightening exercise to relearn walking normally
326.18 -> in this exercise also the forefoot always remains in contact with the floor and never losses its contact or moves (therefore it is considered in level-1 gait training)
344.92 -> this exercise can also be performed along with some functional or recreational activity
355.32 -> if patient finds it difficult to gain control over this exercise, then we can design some supplementary exercises to help patient develop the necessary knee control
366.98 -> such exercises will be discussed in other videos later on
371.2 -> one can always consult and take help for their patient from a qualified neuro therapist to address such specific problems
378.52 -> the neurotherapist will help by suggesting exercises to develop necessary motor control for normal walking
384.98 -> when a stroke patient starts performing both the exercises easily,
389.72 -> and patient is also able to push down with his hemiplegic hand while performing the exercises
396.32 -> then we can progress the patient to level 2 gait training exercises
401.26 -> which we will be discussing level in our next video
405.62 -> see you soon in the next video
408.62 -> till then keep learning, keep sharing and stay connected
Source: https://www.youtube.com/watch?v=rp3OGIvoUQk