Treatment

Gait Training

Gait training refers to helping a patient relearn to walk safely and efficiently. Gait training is usually done by rehabilitation specialists who evaluate the abnormalities in the person’s gait and employ such treatments as strengthening and balance training to improve stability and body perception as these pertain to the patient’s environment. Gait training often incorporates the use of such assistive devices as parallel bars, walkers or canes to promote safe and proficient ambulation. In order to walk again without assistance, the patient will need mental attentiveness and adequate sensation, coordinated with adequate musculoskeletal functioning and motor control.

Purpose

A person’s gait is a pattern of stepping or walking that is specific to that individual. Gait training is needed to help a specific patient gain proficient and safe ambulation within and outside the home with or without an assistive device. Patients usually require gait training if there is some lower trunk or lower limb dysfunction. This dysfunction is often associated with neurological or orthopedic impairment. Complications that may require gait training include:

• Muscle weakness
• Deformity
• Spasticity (the presence of abnormal involuntary muscular contractions)
• Loss of sensation due to injury or disease that results in inaccurate sensory information and unsafe or inefficient motion
• Pain in the weight-bearing joints of the lower extremities, which causes distortion of normal gait

These complications may result from injury to or amputation of the lower extremities; surgery; osteoarthritis or other disorders of the weight-bearing joints; muscular dystrophy; muscle atrophy due to long periods of inactivity or bed rest; lesions of the brain or spinal cord; or changes in perception and other body functions that are part of the aging process.

Normal Gait

In order to understand gait training, you may find a descriptive outline of normal human gait helpful. Human gait is measured from heel strike to heel strike, also known as the gait cycle or “one stride.” The gait cycle has two phases, the stance (about 60% of the cycle) and the swing (about 40%). The point at which the body’s weight is transferred from one foot to the other, when both feet are touching the ground, is called double stance or double support time. The speed of a person’s walk is called the gait velocity, and the rhythm of their walk is called the cadence. Cadence is usually related to the length of the person’s leg and their overall height; short people typically take smaller steps at a more rapid cadence while taller people take larger steps at a slower cadence.

Deviations in Gait

Deviations from normal gait can occur in any portion of the lower extremity. Common abnormalities include:

• Ankle/foot. Deviations of stance include foot slap and foot flat. Deviations of swing include toe drag (foot drop).
• Knee. Abnormalities of stance include hyperextension of the knee. Abnormalities of swing include limited flexion of the knee.
• Hip. Deviations of swing include circumduction and “hip hiking.”
• Trunk. Deviations of stance include lateral lean (Trendelenberg gait), backward lean (gluteus maximus gait), and forward lean.
• Other. Ataxia (loss of muscular coordination) and antalgia (limping from pain).

Deviations can occur together as a group of compensations for one impairment. For example, a patient’s gait may show foot drop as well as hip hiking.

Patient assessment

In determining the patient’s readiness for gait training, the therapist will evaluate the patient’s physical abilities (weight-bearing, strength, stability, coordination and balance) and his or her mental and emotional readiness for gait training. Routine evaluation of elderly patients who are begining to develop gait problems may be done by a primary care physician, but assessment of complex disorders usually requires a gait specialist. A simple evaluation of a patient’s gait can be performed in a straight hallway without pictures or other objects that may distract the eye. The examiner will need a stopwatch for timing and a T-square to measure the length of the patient’s stride. Advanced evaluation of gait kinetics, however, requires a laboratory with computer and video technology.

Posture Re-Education

Posture Re-Education is a means of treating common joint and back pain… Everyone’s posture naturally degrades as they age. This is the result of gravity’s affect on the body over many years. Injuries can compound or accelerate the problem. If you are starting to notice the effect of age on your posture, realize that it is more important than ever to integrate posture re-education into your lifestyle. Our knowledgeable staff will instruct you in simple changes to your routine enabling you to maintain an active lifestyle. Proper posture can be a means of addressing a number of common pain conditions. Many lower back, knee and wrist pain problems can be alleviated through posture re-education techniques.

Just Be Fit, Inc. provides individualized posture re-education programs, targeting your specific needs. Our programs address your needs with clear and direct treatments, attacking the problem at its source. We utilize a hybridization of the best therapeutic posture re-education methods to create a program that will work for you. Our caring and knowledgeable physical therapists not only treat the pain-causing posture problems you have now, but also teach you how simple changes in your everyday routine can make a world of difference in preventing future back and joint pain issues.

posture can improve health and physical happiness… Individuals and health professionals alike are starting to see the benefits of proper posture as it relates to pain control, stress relief and relaxation. Just Be Fit, Inc. is at the forefront of this posture revolution. We understand the connection between simple posture friendly choices and optimizing your health and vitality. We believe that your health and overall happiness can be improved through simple posture re-education techniques, which can easily be integrated into your daily routine.

Over time poor posture becomes a habit, and that habit can lead to larger problems in the form of muscular imbalances. Just Be Fit, Inc. understands that you lead a fast-paced and active lifestyle, which can’t simply be put on hold. That’s why at Just Be Fit, Inc., we strive to create customized approaches that will fit the demands of your active lifestyle and treat the problem at its source.

Balance Training

We hear a lot about how to keep our heart and lungs healthy, but not so much about how to keep our balance system healthy. Your balance system includes all the senses in your body that tell you how you are moving, the brain which puts this information together, and the muscles that control your movements.

This complex system needs plenty of regular ‘practice’. As children we develop good balance by practising balancing activities – walking along walls, jumping, spinning and climbing. As adults we tend not to give our balance system the practice it needs. Health problems can also weaken the balance system. The result is that our balance becomes less good.

There are many different ways to carry out the physical activities that keep your balance system healthy. You just need to practice moving around freely in all directions, and increase the strength in your legs and body. You can do as much or as little as you want. Just a few minutes once or twice a day can make a big difference, but you may find you want to do more!

Who can benefit from balance training?

Everyone! People of all ages and abilities need to keep their balance system healthy, and you are never too young or too old to benefit. A healthy balance system helps you to look and feel good – you can move freely and confidently, and will have more energy and strength. Keeping your balance system healthy is especially important if you have problems due to illness, such as joint pain, weakness or dizziness. Balance training can help you get back to normal, and overcome feelings of stiffness or unsteadines

Ultrasound

Ultrasound uses high-energy sound waves to decrease pain and increase circulation to help painful joints and muscles. It has been shown to cause increases in tissue relaxation, local blood flow, and scar tissue breakdown.

Electrical Stimulation

Electrical Stimulation is used to reduce pain, muscle spasm and promote healing. Electrodes are placed on the body in various places to target specific muscle fibers. This treatment helps to enhance the effects of our other treatments.

Cryotherapy

Rehab uses a couple of types of cryotherapy including cold packs and Biofreeze®, a topical pain reliever. Both of these modalities help to decrease pain, inflammation, and enhance the effects of the treatment. They are also key components of our home exercise programs.

Kinesiotaping

Kinesio® Taping Method involves utilizing a special elastic-like tape over and around muscles and/or joints in order to assist and give support to affected tissues as well as to prevent over-contraction. While most people think of tape as a restrictor of motion, this type is designed to support and facilitate normal motion. With this method, the patient can still be a full participant in the activities which he or she desires, just with a bit of aid. Our therapists are fully trained in this cutting-edge method.