I have had great success with the dynamic Rifton Pacer gait trainer matched with Rifton’s treadmill base. Because my clients are completely supported, including their hands and arms, they are safe to work over a moving treadmill base.
Some of my clients even “run” on the treadmill at 2.0 and 2.5 mph as I have placed them up a bit higher and they learn how to move their feet quicker. This increased speed demand challenges eccentric function of the anterior tibialis. Clients learn to manage foot slap or less control of the dorsiflexors as the feet move into midstance.
With this equipment I have also been able to work safely with my clients on reciprocal striding as I kneel behind them on the floor. Let me tell you about three of my clients.
Amanda has cerebral palsy and has had great difficulty taking reciprocal strides. She has had multiple hip surgeries which influence the way she is able to advance her legs. In the dynamic Pacer and treadmill base I have been able to show her parents ways to help her walk at home in her gait trainer. Dad has also helped from one side and has learned how to assist Amanda to improve. It is challenging to develop a reciprocal stride pattern – especially with clients who have spasticity and tonal influences. In my experience parents gain insight into their child’s abilities and struggles, and a deeper understanding and bond is formed. They also have a better understanding of how to assist their child to improve walking in their gait trainer at home. It is not just about pushing them along, but about how to help to improve coordination and understanding.
Because the dynamic pacer also has a spring and side to side weight shift, work over a treadmill allows clients to see how they are taking steps. It is amazing to see another client, Lenore, walk and take reciprocal targeted steps on the treadmill! She has cerebral palsy and also has bilateral 30° knee flexion contractures. She has had significant trunkal and leg weakness and works hard to place each foot down. She moves over her right leg and pelvis more than the left. She is developing control over excessive tone in the left hip adductors. Lenore’s ability to complete a full weight transfer from side to side at the pelvis and hips is challenging. Yet she now can shift her weight over to the left foot with much more success. When working over the treadmill base, coordination and motor planning is greatly enhanced, with better understanding and control.
Watch Lenore in action:
Katie has Rett Syndrome, a severe subluxing patella, and history of surgery of her left hip - with complications. The left leg is shorter than the right. It is difficult for Katie to follow through with movement. She does have her own dynamic Pacer for home use, but has grown to tolerate and even looks forward to walking over the treadmill in the dynamic Pacer here in the office. As you can see on the video, she is taking steps with her left foot successfully as I support and assist her right leg. She uses right hip adduction with flexion to advance the right foot forwards - with active dorsiflexion.
Watch Katie walk on a treadmill:
Amanda, Lenore, and Katie are three examples of clients of mine who are making great strides with the dynamic Pacer and treadmill base. This equipment has surely enhanced my practice.
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