Gait Retraining After Neurological Disorders

Abstract

Abstract Neurological disorders like traumatic brain injury, stroke, and spinal cord injury often adversely affect a person's ability to walk. Restoration of gait function is an important goal in the rehabilitation of these patients. Appropriate motor training can facilitate adaptations in the nervous system to recover function after an injury. Important aspects of motor training include task‐specific performance and repetition of the affected movement. This means that to improve walking, the patient must walk. Body‐weight supported treadmill training is becoming increasingly accepted as a valuable strategy for gait rehabilitation after neurological injury. Treadmills that run at slow locomotor speeds allow patients who are partially unloaded from their body weight to walk, possibly with manual assistance by one or more therapists. However, manual therapy is limited in terms of duration, repeatability, and quantification. Robotic devices allow longer training sessions with better support and control of the leg movements. Current developments are directed to patient‐cooperative strategies, which allow the robotic device to adapt to the patient's needs and efforts. Furthermore, proper design of these devices leaves open many possibilities for a repertoire of additional assessment tools that measure patients’ performance during training and other clinical parameters. Future directions in this field include combining robotic devices with functional electrical stimulation and the development of robotic orthoses for retraining overground walking.