I wish I had a trainer locally that I could refer to work like this. Or I wish Medicare and insurances would pay for therapy long enough, so that I could get my patients into this stage. I feel like the payors force us to give up on the neuro population way too soon. End rant.
On another note, I love how Functional Patterns looks at a pathologic gait cycle from a postural prospective. Cue the choir of angels. I also love all the verbal cuing he’s giving. I wish there was some more tactile cuing going on. Most of the people I work with would fall closer to the motor moron category– ask them to anterior tilt their pelvis and they look at you like your speaking Greek. However, watching this I realize I’m not the best at verbal cuing. I had a patient tell me once that she loved my style of gait training, because her former therapist, “Told me just walk. She didn’t help me to walk [with tactile cues.]” I try to remember her when I’m gait training. “Just walk” further ingrains the patient’s compensations; whereas, verbal and tactile cues guide the patient to change their biomechanics and gait efficiency. It is important to get biomechanics and efficiency as close to “normal” as possible in any movement and even more so with complex movements like the gait cycle, because that “normal” is how we were designed to function. You can ask a cat to fly, but it probably won’t do so well. Same thing with your body. You can ask your body to work outside the “normal” biomechanics and it will because it’s amazing… for a time, then you start to get pain. Pain is a warning signal that if you keep on like this, damage will (or perhaps has begun) to occur. Move correctly, every time.
The end of this video also highlights why I’m not really a fan of one-sided assistive devices– canes, hemiwalkers. They encourage other compensations that are mostly definitely not “normal” biomechanics. Some of my colleagues and patients rile me about that, because walkers can be so bulky and annoying. I’d rather train straight from the walker to no device, so that you don’t have to create another step in order to correct the compensations created by the one-sided devices. I really only use the one-sided devices on the folk that don’t have a functioning hand grip on one side. Although, truly those are the people that usually need to not have one-sided device the most!