Gait Analysis Continuing Education

Chapter Details and Course Objectives for this Gait Training Physical Therapy Course

Upon successful completion of this course, the participant will be able to:

• Identify musculoskeletal dysfunction that contributes to gait abnormalities.
• Discuss normal joint motion throughout the kinetic chain through the phases of gait.
• Identify evidence-based practices for best rehab outcomes with specific diagnoses.
• Identify contributors to abnormal movement patterns.
• Discuss the movement analysis model, the purpose and usefulness when developing effective rehab tasks and programs.
• Discuss comorbidities and the impact each on gait function.
• Identify how gait impacts ADLs and community participation and develop techniques to assist patients to function within community
• Differentiate specific musculoskeletal and neurological dysfunction leading to gait dysfunction.
• Systematically analyze gait abnormalities and prioritize treatments focused on improving function.
• Analyze movement patterns associated with specific tasks that involve gait.
• Develop task-specific treatment plans and gait training exercises to improve functional gait.
• Identify upper extremity factors that contribute to gait dysfunction and develop techniques to address upper extremity.

Learn From the Expert - Kimberly A. Contryman, PT, DPT, NCS, OCS

Kimberly A. Contryman, PT, DPT, NCS, OCS earned her masters of physical therapy in 1991 from Northern Arizona University. She was NDT certified in 1995, received her certification as a neurology specialist by the APTA in 2000 and received her certification as an orthopedic specialist in 2002. In May of 2002 the University of Southern California awarded Kim a doctorate of physical therapy.

The Science and Biomechanics of Gait

Analyzing gait, evidence based practice, normal phases of gait, lower trunk and pelvis, upper trunk

What is gait training?

• Analyzing gait
• Evidence based practice
• Normal phases of gait
• Lower trunk and pelvis
• Upper trunk
• Elomotus® Muscle Technology Animations of the Gait cycle

Muscle Activity in Gait - Elomotus® Muscle Technology

• Understanding muscle function during gait
• Exploring and understanding the function of muscles
• gluteus maximus
• hip adductors
• abductors
• tfl
• quads
• hamstrings
• triceps surae
• tibialis anterior
• toe extensor

Neuroanatomy and the Gait Cycle

Multi-sensory information such as visual and vestibular sensation work together so that functional gait can be achieved.

• Corticospinal tracts
• Rubrospinal tract
• Reticulospinal
• Vestibulospinal tract
• Tectospinal tract
• Medial longitudinal fasciculus
• Brainstem
• Cerebellum
• Cerebrum
• Frontal lobe
• Parietal lobe
• Temporal lobe
• Occipital

Investigate the neuro shoulder and its impact on the gait cycke

Functional Gait Movement Analysis

• Training for function, efficiency
• Creating treatment plans, prioritizing, task analysis
• Common gait abnormalities with neuro patients
• Contributors to abnormal movement, posture, balance, risk for falls
• Everything is connected, pelvis, hip, lumbar spine, foot and ankle
• Movement and task analysis lab demonstrations
• Breaking down components from sit to stand from observing posture
• Discussing sitting posture and translation to movement

Podiatrist Interview - Factors And Diagnoses Affecting Gait and Gait Training

• Understanding foot biomechanics and gait training
• Neuropathy and its effect
• Understand the causes of neuropathy and approaches
• Therapy for patients with neuropathy
• The importance of proper eval, balance training, home analysis, and communication
• Big toe joint problems, bunions, secondary back issues, surgical options and risks
• Shoe options how to assess a proper shoe for proper gait
• Orthotics in the shoe - pro or con?
• Cortisone injections for arthritis
• Understanding plantar fasciitis
• Understanding ankle-foot orthosis, and orthotics
• Rigid orthotics are they beneficial?

General Surgeon - Discussion of Comorbidities and Gait Training Physical Therapy

• Oncology patients, chemo side effects, diabetes
• Deconditioning and amputation

Case Presentation - L1 Burst Fracture

• Subjective and objective analysis of the gait pattern
• Multi-cameras view of gait cycle with AFO, walker and assistive devices
• Therapeutic gait exercises for specific patient gait abnornmalities
• Use of PNF techniques to enhance gait

Case Presentation 2: Lymphedema Bilateral Lower Extremity Cancer, Chemotherapy And Radiation

• Patient Interview concerning the treatment process
• Subjective and objective analysis specific to the diagnosis
• Gait analysis and training with walker and AFOs
• Gait training with cane while wearing AFO
• Patient discussion of braces and there impact.
• Discussion of brace type and reason for the specific bracing
• Gait analysis with walker and without braces
• Therapeutic exercises while wearing braces: balance with ball, UE dissociation
• Therapeutic exercises using gym equipment to increase strength to improve functional status, building endurance and stamina
• Therapeutic exercises for the upper extremity to enhance gait along with core strengthening
• Therapeutic exercises using the hip machine, gluteus medius strengthening, endurance training for hip musculature

Case Presentation 3: Spinal Tumor

• A discussion with the patient concerning alternate treatments
• Subjective and objective analysis specific to the diagnosis
• Gait without cane
• Ankle-foot orthosis and AFO description
• PNF techniques, muscle activation
• Therapeutic gait exercises using the gluteus medius and gluteus maximus

Case Presentation 4: Parkinsons Disease

• Case Study review for patients with Parkinsons Disease with regard to gait training, exercise and rehab
• Subjective and objective gait analysis specific to Parkinsons Disease
• Therapeutic exercise for gait training for Parkinson patients including gait balance exercises
• Patient Interview detailing the challenges and success of this patient
• The effectiveness of Tai Chi for functional gait physical therapy
• Changing speed of gait for enhanced gait analysis

Case Presentation 5: Stroke Patient, Fibromyalgia, Subluxation, Lower Extremity Swelling

• Performing transfers with stroke patients
• Gait analysis with hemi walker
• Gait training with support for upper extremity
• Therapeutic exercise - sit to stand
• Gait training pearls for this patient population
• Understanding gait abnormalities/treatment

Case Study 6: Parkinson’s Gait, Task Analysis, ADL’s, Community Programs to improve Coordination and Balance

• Gait analysis
• Tasks to decrease anxiety and tremors
• Tai Chi
• Altering gait speed for detailed analysis and rehab
• Task analysis of Gait related activities

Exercises and Manual Therapy To Enhance Gait Function

• Incorporating therapeutic exercise - quadruped
• Therapeutic exercise exercises in kneeling
• Manual therapy for hemi shoulder
• Using balance tests, scales, blood flow resistance training

Course Test - Evaluate your knowledge

• Use the Healthclick proprietary online education system which provides the online student with:
• Worldwide access to high definition video, anatomical animations and images, and written information
• The highest quality film in the industry, you can see the difference!
• Stop and resume within a course, the Healthclick system will optimize your course based on your device, connection and remembers where you left off.
• Real-time course updates. We are always adding to each courses, updating content, adding animations, these are not static courses!
• Evaluate your knowledge with the course test on any device.
• Print your state course certificate for CE credit.
• Take the online test as many times as need in order to achieve a 70 % or greater score.