Locomotor Training: Principles and Practice
Susan Harkema, PhD, Andrea Behrman, PhD, PT, and Hugues Barbeau, PhD
Abstract
Locomotor training is an emerging rehabilitation intervention for recovery of function after neurologic injury or disease and the physiological basis and scientific evidence supporting its use is discussed in this book. The book also reviews physical rehabilitation for posture, standing, and walking from a historical perspective that provides a context for the emergence of locomotor training as an activity-based therapy after spinal cord injury (SCI) and stroke by implementing evidence-based practice providing new strategies to augment already successful therapeutic approaches. As an activity- ... More
Locomotor training is an emerging rehabilitation intervention for recovery of function after neurologic injury or disease and the physiological basis and scientific evidence supporting its use is discussed in this book. The book also reviews physical rehabilitation for posture, standing, and walking from a historical perspective that provides a context for the emergence of locomotor training as an activity-based therapy after spinal cord injury (SCI) and stroke by implementing evidence-based practice providing new strategies to augment already successful therapeutic approaches. As an activity-based therapy, locomotor training provides activation of the neuromuscular system below the level of lesion with the goal of retraining the nervous system to recover specific motor tasks related to mobility, posture, standing, and walking. The book presents the four guiding principles that serve as the basis for clinical decisions throughout the three components of locomotor training. Successfully providing the locomotor training intervention is dependent on knowledge, skill, proper equipment and attire, and clinical decisions for progression. Community integration prepares the client for functioning at home and in the community. The primary goal of both overground assessment and community integration is to translate the capacity of the nervous system developed during step training to walking at home and in the community. The locomotor training intervention is implemented by identifying specific goals based on the current phase of recovery. Properly and continuously challenging clients to achieve higher levels of performance is critical to recovery. Even though the accomplished neural plasticity may not have yet resulted in reaching functional goals such as transferring, standing, or improvements in walking, the assessments in the phasing will show more incremental changes in neural recovery. The sequence of implementing these specific goals is based both on the scientific evidence and the experience of many physical therapists who have provided the intervention in research and clinical environments over the past decade.
Keywords:
locomotor training,
rehabilitation intervention,
recovery,
neurologic injury,
neurologic disease,
posture,
standing,
walking,
activity-based therapy,
spinal chord injury
Bibliographic Information
| Print publication date: 2011 |
Print ISBN-13: 9780195342086 |
| Published to Oxford Scholarship Online: September 2011 |
DOI:10.1093/acprof:oso/9780195342086.001.0001 |
Authors
Affiliations are at time of print publication.
Susan Harkema, PhD, Author
Department of Neurological Surgery, University of Louisville, Louisville, KY.
Andrea Behrman, PhD, PT, Author
Department of Physical Therapy, College of Public Health and Health Professions, University of Florida, Gainesville, FL.
Hugues Barbeau, PhD, Author
School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada.
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