The goal of most lower-limb amputees is to be able to walk the same way they did before their amputation. Walking “normally” is defined as a symmetrical gait pattern that falls within a certain range in terms of posture, step length, rate of speed and limb positioning. Using a prosthetic device makes this range difficult to achieve without using excessive energy. In most cases, the higher the amputation level, the more gait deviations there are.
Almost all lower-limb amputees will benefit from gait training during their recovery. Since using a prosthetic device is a challenge for new amputees, they have the most to gain. Gait training usually starts with parallel bars and, as stability becomes more consistent, advances to a walker or crutches. Eventually, trainees will start using a single cane or no assistance at all!
If you have been wearing a prosthetic device for many years, you can still benefit from gait training to get a tune-up or learn a new skill.
While many different techniques can be used in gait training, the two that stand out are “splinter skills” and a “whole walking” approach. When teaching “splinter skills”, the gait pattern is broken down into a sequence of events. The trainee will practice each of these events separately before putting them together to make a complete gait pattern. The “whole walking” technique relies on the body’s natural tendency to find the most stable way to walk and an entire gait pattern is practiced. The best strategy is determined by the therapist based on each individual’s needs.
Teamwork between the trainee, prosthetist and physical therapist goes a long way in helping lower-limb amputees reach their goals. It is important that everyone is willing to seek out the best option and work hard to make the most out of each opportunity.