A Move to Improve - 12: Gait cycle
Ageing causes many change in your life. A major change that has a huge impact on safety is your walking pattern.
The traditional posture and walking style we think of for the elderly is stooped and shuffling. There are many causes for the slow change: decline in strength, endurance, bone structure, injuries, disease, confidence, reaction time and awareness.
Some things we can improve and some we can't. Awareness, confidence, strength and reaction times are all aspects of walking that can be improved with training.
Exercises such as: stepping over objects, walking on uneven surfaces or responding to distractions; can assist in improving gait and preventing falls. The aim of these exercises is to provide a safe environment where the patient can practice lifting their foot higher, spend more time with only one foot on the ground or have to respond quickly without fear of falling over. This provides confidence for them to continue the same movements outside and at home.
The awareness of walking incorrectly unfortunately is difficult to teach as it is a slow change over time. This can be done simply by a discussion but sometimes needs mirrors or video recording for the patient to truly understand how poor their walking has become. Often once the patient understands and accepts what they are doing compared to normal improvements can be made faster.
The ultimate goals are to have an upright posture to ensure a good view of any obstacle and keep the centre of gravity within the base of support and to step evenly with each foot to allow good foot clearance with controlled weight shift of the torso. Speed and step length play a lesser role but are still important.
The proper gait cycle includes: heel hitting the ground with a bent knee; straightening the knee as you roll onto your foot and shift weight onto the stance leg; rolling onto the toes and you push forward with your calf and glute muscles whilst bending your knee and shifting weight to the other leg; keeping the knee bent and toes up and it swings through in front to strike heel first onto the ground again. There are many intricate movements and supporting muscles that need to work in perfect synchronisation to create the correct gait pattern. If there is only a small change the whole movement chain is effected. It often takes someone like a Physiotherapist notice the issue and facilitate the improvement.
Like most situation everything becomes better with practice - it is best to practice the right thing, the right way.
Life is too short to waste time walking incorrectly