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Journey of a DPT Student

Gait Training as a PT Student

Published September 24, 2012 2:38 PM by Lauren Rosso

The single most awkward simulated task in PT school has to be practicing gait training on classmates. It goes without saying that none of us are very good at acting, and even if we are, we can't possibly "present" with all of the complications that an actual patient would. Now that we've progressed further into the neuromuscular courses, a lot of the concepts are becoming more clinically based. We're applying things like gait training to specific subpopulations - stroke, spinal-cord injury, amputees etc. But no matter how hard we try, we just can't make the situation realistic.

What's more awkward is working with an instructor who is a gait training rock star (both with facilitating and acting). You'll watch this 5-foot-1 woman dependently stand her 6-foot-4 counterpart, who despite being neurologically intact can perfectly imitate a patient who has had a stroke. Next, they always ask for a volunteer to demonstrate, and all I can think is, "How do I follow that?" It's really impressive, but as a student it's also very intimidating.

Gait training is obviously a huge part of physical therapy, and I'm sure that the only way to become comfortable with it is to practice with actual patients. At the same time, you want to feel confident before you are in a "real" setting. There just doesn't seem to be a good simulated environment for us to learn in. For now, we'll just have to struggle through the awkwardness and hope that the skills we practice in class will translate into a clinical setting.

3 comments

Hi Lauren,

I remember having very similar feelings and concerns before getting some hands on practice with real patients. We can try to mimic the possible patient presentations we are likely to see in the clinic but even a 'professional actor' cannot imitate the unpredictability, fatigue, and cognitive impairments that can accompany a patient receiving gait training therapy. I just finished a 10 week clinical rotation as a member of the stroke team at a rehab hospital. Needless to say, gait training and gait assessment was part of nearly every evaluation and treatment session I conducted.

Just like any PT diagnosis, every patient presented a little differently. Gait training a 5’2” 110 lb 24 yo female s/p MCA CVA was very different than gait training a 6’4” 250 lb 76 yo man s/p MCA CVA.  Add in the cognitive and attention deficits and gait training becomes a whole new and different challenge.  Getting hands on gait training experience on ‘real’ patients is an invaluable learning tool but because there are so many different gait deviations I think we will be constantly challenged by the variety and diversity of patients we see.

Kelsey March 27, 2013 1:34 PM
Greenville NC

Hi Lauren,

I am a student in my first year of school for physical therapy and just completed a test in my motor control class on gait progression, stability, and adaptability.  While we have learned the signs and typical impairments of patients with various neurologic disorders, it is also hard for me to think of applying this information into a clinical setting.  We haven't begun simulated gait training with classmates yet but imagine that with gait being such an automatic form of locomotion, it will be very difficult to accurately depict what these patients are really dealing with and the demands it will place on us at PTs.  I am beginning my first clinical experience later this month and excited to get a more hands-on approach with the information we have learned.  

Megan March 11, 2013 9:56 AM
Greenville NC

Lauren,

After reading this post I could help but comment. We are studying these same neurological conditions now and I am experiencing some of these same woes. While some of my classmates seem to be good actors we all worry about how these conditions will truly present in the field. Our instructors do a good job of creating an environment as close to the clinic as possible, but I have to agree with you there is no true substitute. I think this could even apply to musculoskeletal conditions in evaulation recognizing signs and symptoms along with positive and negative special tests. We leave for our first clinical in less than 3 weeks so we are all anxious to see how ready we are for the "real deal". I can't wait to get some real life application of what we have learned.

Ben Alexander, , DPT Student East Carolina University March 6, 2013 2:31 PM
Greenville NC

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