Prosthetic gait training - Improvement of core stability and stance phase | Ottobock

Summary

This video script focuses on prosthetic gait training, emphasizing core stability and the stance phase to enhance walking performance. Through a series of exercises demonstrated by Franziska and Gerhard, users learn to shift weight to the prosthetic side, activate hip extensors, and stabilize the hips. The exercises aim to increase the length of the stance phase, strengthen core muscles, and improve balance. With progressive difficulty and the use of balance boards and straps, users work to maintain proper posture, engage key muscle groups, and achieve a secure and dynamic gait, enhancing overall mobility and confidence.

Takeaways

• 😀 The first exercise focuses on shifting the load to the prosthetic side while maintaining an upright upper body and preventing lateral trunk and pelvis movement.
• 😀 A strong stance phase is vital for secure gait training, and exercises should progressively increase in difficulty to challenge the user.
• 😀 The goal of the stance phase exercises is to activate the hip extensors and move the center of mass forward dynamically.
• 😀 The prosthetic knee joint identifies certain exercises as steps, allowing for stance release, but a subsequent hip flexion movement triggers the swing phase.
• 😀 Proper understanding of knee joint functionality is critical, and users should learn to initiate the swing phase by flexing the residual limb after the knee extends.
• 😀 Exercises focus on shifting weight to the prosthetic side and training hip extensors and abductors, while stabilizing the upper body.
• 😀 Using a balance board helps to train the prosthetic side's strength and stability, with movements requiring hip stabilization and preventing lateral tipping.
• 😀 Alternative exercises such as shifting a sheet of paper forward and backward with the contralateral leg provide similar training benefits to the balance board.
• 😀 Core stability exercises, such as using a strap to train hip stabilization, improve dynamic stability while standing and walking.
• 😀 Side steps and movements against resistance from a strap engage core muscles and hip abductors, strengthening the body for a safer gait.
• 😀 Strengthening core muscles is crucial for a safe, stable, and dynamic gait, with emphasis on maintaining proper alignment and posture during movements.

Q & A

What is the main objective of the exercises in this prosthetic gait training session?

The main objective is to improve core stability and enhance the stance phase during gait, which is critical for a secure and dynamic walking pattern when using prosthetic knee joints.

How does the first exercise help improve the stance phase?

The first exercise helps by shifting the load to the prosthetic side while ensuring the upper body remains upright. This stabilizes the pelvis and prevents lateral leaning, laying the foundation for a secure stance phase.

What is the significance of the trunk and pelvis alignment during the first exercise?

The trunk should remain upright without lateral leaning, and the pelvis should not drop laterally. This ensures proper posture and alignment, helping to activate the correct muscles during the stance phase.

How does Franziska progressively increase the difficulty of the first exercise?

Franziska gradually reduces the security measures and later incorporates arm movements, which adds complexity and forces the body to stabilize more dynamically during the exercise.

What is the role of hip extensors during the second exercise?

The second exercise activates the hip extensors more intensively, allowing the center of mass to move forward dynamically, which is crucial for extending the stance phase while walking on level ground.

Why does Gerhard not initially feel the stance release during the second exercise?

Gerhard doesn't feel the stance release immediately because the knee extension moment, caused by the ground reaction force, has not yet triggered it. He only activates the swing phase through hip flexion after extending the knee.

What is the importance of actively initiating the swing phase after knee extension?

Actively initiating the swing phase after knee extension helps Gerhard understand the knee joint's functionality and prepares him to transition into the swing phase more effectively.

What is the goal of the exercise involving the balance board and prosthetic side weight shift?

The goal of this exercise is to shift the user's weight to the prosthetic side while training the hip extensors and abductors, promoting better hip stability and coordination without lateral tipping.

How does Gerhard ensure proper form while using the balance board?

Gerhard ensures proper form by keeping his hips stable, not allowing them to drop, and using his hands only for stability while moving the board sideways. This engages the abductors and posterior glutes for effective training.

What alternative exercise can be used in place of the balance board for training the prosthetic side?

An alternative exercise involves using a sheet of paper on the ground, which Gerhard shifts forward and backward with the contralateral leg. This mimics the movement of the balance board while strengthening the same muscles.

How do core muscle exercises improve prosthetic gait training?

Core muscle exercises strengthen the muscles necessary for maintaining stability during stance and movement, such as the hip abductors and the core itself, leading to a safer, more dynamic prosthetic gait.

How does using a mirror assist Gerhard during the core muscle exercises?

The mirror allows Gerhard to independently check his form, ensuring that his shoulders remain relaxed and that his hips do not rotate during the movement, helping him perform the exercises with correct alignment.