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Home >> Blog: Stroke Awareness

Blog: Stroke Awareness

May is Stroke Awareness Month. One of the most debilitating problems stroke survivors must contend with on a daily basis is difficulty walking. Relearning how to walk is a major focus in stroke rehabilitation, but there are several barriers to achieving fluid, efficient walking patterns post-stroke. Postural abnormalities, asymmetric strength, and motor control are driving forces in the typical uneven gait pattern used by stroke survivors.

Did you know that LiteGait was developed specifically to address the postural deficits that prevent stroke survivors from using a smooth, efficient movement pattern while walking? By correcting postural alignment in a fall-free environment, the stroke survivor not only gets more practice walking, but the nature of that practice is also better. Removing the fear of falling and correcting postural alignment allows for greater freedom of movement and more attention is paid to the task being learned, rather than just “not falling.

Since the therapist no longer has to support the learner to prevent falls, they can provide assistance where the person really needs it, often at the leg that doesn’t seem to cooperate. They can also take a step back and really see where the problem is. What, specifically is preventing the person from walking more fluidly and efficiently? Then they can give more precise instruction to promote learning of a better, more efficient walking pattern. The observational analysis could immensely be improved with objective measures and even further by real-time biofeedback of the patient's performance.
Accepted wisdom is that once a stroke survivor establishes a walking pattern, it is very resistant to change. Why is that? They are certainly capable of learning, so why can’t they change the way they walk once they start? What stops them from “unlearning” bad habits related to walking? One factor is that they actually aren’t aware that what they are doing is “wrong.” If someone can’t feel that their steps are uneven, why would they change that?

The GaitSens instrumented treadmill and tablet specifically address that issue. It is designed to measure and analyze the person’s walking pattern in the moment, while they are walking on the treadmill. It then provides visual and auditory feedback to the person with every step they take while walking on the treadmill. It keeps score, allowing the person to self-correct their walking pattern while achieving the specific goal selected by their therapist, based on the person’s own walking pattern. As they improve, the measured changes can be used to set new goals! What a smart use of technology to aid in the delivery of effective, intensive, individualized therapy.

Most stroke survivors have more return of function in the leg than in the arm. Part of the reason for this might be that it’s easier to “get by” single-handedly than with the use of just one leg. But another reason might be that arm function is very dependent on postural alignment, perhaps much more so than leg function.  The shoulder blade “sits” on the ribs, helping to position the shoulder, and therefore the arm, for function.

When postural dysfunction is severe, as is common in stroke survivors, the shoulder has a poor base of support, and arm use suffers. This contributes to the arm “problems” so commonly seen in stroke survivors. The arm is held tightly against the ribcage, or the arm hangs dependently at the side and the hand cannot be positioned for use. If spasticity is present, the arm tends to pull in strongly and cannot generate pushing force.
Enter the LiteGait, the only body weight support system specifically designed to correct the user’s postural alignment of the trunk in an upright position. The “start” of LiteGait was to correct postural alignment for walking in stroke survivors, but now that it has reached widespread acceptance for gait rehabilitation, its broader applications are becoming obvious.
Postural impairments don’t just affect walking. They affect arm use as well — perhaps even more than leg movement. With postural correction, the shoulders are positioned evenly, above the hips without collapsing forward, to the side, or backward. With this better alignment, the shoulder has a good base to work from. Add to that a fall-free environment, so the arm no longer has to reinforce upright posture, and the arm is freed up for function.
Try combining postural support of the LiteGait with interactive upper extremity activities such as using Q-pads to promote reach and pressing with the hands, building precision and strength. Q-pads are portable therapy devices that provide immediate visual feedback, letting the person know how hard they are pushing. Since they are magnetic, they can be positioned on the wall just as easily as they can be placed on a table. By adjusting the sensitivity, activities can be made easier or harder with the push of a button, to meet each patient’s individual needs. Once they develop some “pushing proficiency,” they can light up in random order, challenging the person’s cognitive ability or reaction time!