Clinical Pilates in Practice: Motor Learning & Gait (September 2022)
This research was designed to validate a simple, low-cost push-off retraining protocol in healthy participants based on task-specific training that could be implemented during overground walking in the clinic.
Bertrand-Charette M, Nielsen JB, Bouyer LJ (2021) A simple, clinically applicable motor learning protocol to increase push-off during gait: A proof-of-concept. PLoS ONE 16(1): e0245523.
KEY POINTS: MOTOR LEARNING & GAIT
- Gait control is often compromised after neural injury.
- Error-based motor learning protocols can improve overall walking ability in neurologically impaired populations.
- Experimentally-controlled error-based motor learning is a potential protocol for training motor recovery after injury.
Reduced push-off force is a prevalent gait impairment, which correlates to a reduced gait speed and limits mobility and activities of daily living.
- Applying controlled perturbations during gait in the laboratory setting can induce error-based motor learning.
- In this study, the presence of after-effects following removal of the push-off training system, supports the hypothesis that it is possible to modify the feedforward command controlling ankle plantar flexors during push-off.
- The motor learning process is usually specific to the trained leg.
- There is a correlation between lower limb strength and gait speed.
- Increases in gait speed make it possible for patients to meet the minimal requirement to be functional in society.
- Increasing muscle strength can therefore support an increased the gait speed for patients.
CLINICAL PILATES IN PRACTICE
Double leg and single leg calf raises should be performed with the knee straight and bent, to emphasize both gastrocnemius and soleus strength, and then integrated into positions of hip extension to mimic the push off phase of gait.
- Calf Raises and Prancing on the Reformer with the foot bar low to work closer to hip extension.
- Sleeper/Side Lying Leg Press on the Reformer with the hip in extension necessitates ankle integration.
- Placing the straps/handles around the forefoot for sprung leg work will incorporate a stability challenge as the ankle and forefoot work through plantarflexion.
- Walking or Bicycles on the Trapeze Table.
- Standing Leg Press/Walking in standing at the Tower.
- Integrate a step over when performing standing foot press with the Foot Corrector.
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