Gait Training and Neurological Conditions: Exercise Prescription to Improve Walking for People with Neurological Conditions 

The ESSA Victoria State Chapter is proud to present this presentation on Exercise Prescription to Improve Walking for People with Neurological Conditions. 

Gait disorders are common in the most prevalent neurological conditions across the lifespan; cerebral palsy (CP), traumatic brain injury (TBI), multiple sclerosis (MS), Parkinson’s disease (PD) and stroke. Together these conditions cost the US $218 billion annually. The good news is that these conditions have very good long-term survival. The bad news is that reduced mobility (i.e. walking) and low participation (i.e. lesser engagement in work, leisure, social or sporting activities) is a hallmark for each of these conditions. For example, 75-90% of people with moderate-severe TBI do not return to their pre-morbid activities, and of those living with stroke, many have a resulting disability, with 75% of people not walking fast enough to resume their pre-morbid activities. 

The past 10-15 years has seen dozens of strength training RCTs report improved muscle strength, but little translation into mobility gains. The recent Stroke Foundation guidelines, and the US stroke guidelines both make a ‘strong’ recommendation for strength training for those with muscle paresis. However, both also state that the optimal strengthening protocol is not known. It is clear that strength training improves muscle weakness after neurological injury, yet greater strength has not translated to improved walking outcomes. Strength training for walking has failed for three main reasons. Firstly, previous promising interventions have failed due to poor staging of pilot studies. We have systematically developed and tested our exercise protocol in humans, and conducted a successful pilot RCT.  Secondly, the main muscle groups responsible for propulsion when walking have not been targeted. Most studies have targeted the quadriceps and hamstrings, even though they make only a negligible contribution to forward propulsion. Thirdly, the strength training protocols used in stroke studies have not followed the American College of Sports Medicine (ACSM) guidelines for the implementation of strength training to improve functional performance. Some studies have used ASCM guidelines for progressive resistance training, a method of high resistance and slow movements that is widely accepted as the most effective way to improve muscle weakness. 

This webinar will cover key areas related to the biomechanics of walking, muscle function and power generation for walking, and the ACSM guidelines for strength training. A key focus will be how clinicians can link these well-established bodies of evidence together to improve exercise prescription for walking limitations, so that rehabilitation outcomes are optimised.

Presented by Prof Gavin Williams, PhD, FACP 

Prof Gavin Williams PhD FACP has worked in neurological rehabilitation for nearly 30 years. He is the inaugural Professor of Physiotherapy Rehabilitation, a joint position appointed between Epworth Healthcare and The University of Melbourne. Prof Williams was awarded Fellowship to the Australian College of Physiotherapists in 2011. He is a representative to the WHO Development Group for the development of the ‘Package of Interventions for Rehabilitation’ for Traumatic Brain Injury, and physiotherapy representative to the MRFF Mission for TBI. 

He has over 120 peer-reviewed journal publications and over 200 international and national conference presentations. Prof Williams is an expert in the assessment and treatment of gait disorders following TBI, as well as spasticity management and outcome assessment. His work has been used in numerous treatment guidelines and he has several book chapters on the physical management of people following TBI. Prof Williams will contribute to the guidelines for the physical assessment and treatment of people with TBI.  

Since he began working at the Epworth Hospital 25 years ago, he has developed a program to teach advanced gait and running skills to people with neurological injuries.  Since that time he has been a Post-doctoral Research Fellow focusing on the rehabilitation of people with neurological conditions, particularly targeting 
1) the assessment and treatment of mobility limitations 
2) resistance training 
3) spasticity management 

Schedule

Wednesday, 23 June 2021
6:00pm - 7:30pm AEST
 
Please note, the times listed are in Australian Eastern Standard Time. 
Your local time will be: 

ACT:		6:00pm - 7:30pm
NSW:		6:00pm - 7:30pm
NT:		5:30pm - 7:00pm
QLD:		6:00pm - 7:30pm
SA:		5:30pm - 7:00pm
TAS:		6:00pm - 7:30pm
VIC:		6:00pm - 7:30pm
WA:		4:00pm - 5:30pm

Please note: This is a live webinar and needs to be watched at the specified time above. If you are unable to watch the webinar live, it will be produced as a podcast and can be purchased within the following month.

Rates per person

ESSA Member		$30.00
Non-Member		$50.00
ESSA Student Member		$15.00
Student Non-Member		$25.00

Please see terms & conditions for registration type definitions.

Access to Webinar

You will be provided information on how to access this webinar within your registration confirmation email.
NB: A confirmation of your attendance is required.
  

Target Audience

Any Accredited Exercise Scientist and/or Accredited Exercise Physiologist  

ESSA CPD Points

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