Objective

The objective of Phase V is to provide advanced functional gait training for our clients who are moving their legs or are able to walk with or without adaptive aids. 

The foundation of our Functional Gait Performance Program™ is education and workout design. Our goal is to teach each client the tools necessary to improve on their own, allowing out-of-town clients to return home and continue their progress.

Our “finishing school” was created out of demand. Some clients in the walking phase come to us with almost perfect gaits, while others compensate so much that walking long distance isn’t an option. We have determined that the difference is not due to the level of injury, but how these people were trained over the years and what was expected of them. Their gait is not predetermined but developed through the stimulation received.  Over time, just as with any person, compensation leads to loss of function. It is not only a problem with SCI, but a normal response to an inefficient gait pattern. Correcting this compensation isn’t easy, but with the right stimulation, workout program and client determination, improvement can happen. At Project Walk, we believe that progress only stops when the client is satisfied with his or her results.  

Theory of Drills and Skills

We don’t teach you to walk; we teach you the skills necessary to walk well.

It is our philosophy that a functional gait is determined by the coordination between your mechanical center of gravity (pelvis) and your balance (ankles and inner ear). You don’t learn how to coordinate these factors walking in parallel bars or on a mechanical gait trainer. To improve coordination and balance you must be able to trust your legs to support and balance you. This is the cornerstone of our Functional Gait Performance Program.

If you want to walk with a functionally sound gait, you must first learn to master the basic skills of controlling the muscles that support and move your hips in a full range of motion.  You must have control of your hip, knee and ankle joints, and you must be able to coordinate these movements with your upper body. Skills you must have are:  the ability to do full knee and hip flexion; maintain control throughout the full range of motion of the femur; move side to side, forward and backwards; and you must be able to go to the floor and get back up in all different body positions. 

Posture and functional range of motion is what sets our training program apart from the rest. Our program has nothing to do with traditional methods or ideas of how someone with SCI recovers. We have a history of training elite athletes and that’s the approach we still use. This is why our clients recover faster, walk better, and are stronger than their peers. Decades ago, teaching coordination within the sports world was something that just wasn’t done. Either you were born with it, or you weren’t. Things have changed since then. Each year performance trainers take average athletes and turn them into scholarship athletes by teaching them all the aspects of performance, including coordination. It is accomplished by stimulating the nervous system with specific drills designed to elicit certain responses. Once that skill has been mastered, programs become more demanding requiring more from the nervous system. At Project Walk, our performance training is designed to elicit a functional gait.

Frequently Asked Questions

Who can benefit from the Functional Gait Performance Program?

• Someone who is walking now and wants to improve
• Someone who has movement in their legs but can’t walk yet
• Someone who has walked, but due to compensation is no longer able to do so

What is the program?

• It depends on the individual’s goals and abilities. For someone who is a more independent walker and is looking to fine tune their gait, the program is designed at Project Walk then taught to the individual or their trainer to be performed at their home or local gym. 
• For those needing more help, we recommend an in-house program for longer than a week. It is more effective and efficient because of the exposure to a variety of our highly skilled staff.
• The misconception is that you have to spend years at Project Walk when in fact we work with clients throughout the world that train at home or at their local gym with their own trainer or therapist, supervised by us. Together, we design a long-term training program to support the client’s goals.

I have been to other programs and they don’t know how to work with me. Are your trainers experienced?
Our Certified SCI Recovery Specialists have thousands of hours of experience and have gone through our intensive certification program. Only the very best become certified in The Dardzinski Method™. 

Is the gait training program a long-term program and commitment?
Yes and no. Clients can continue their progress at Project Walk or go home with the knowledge to workout on their own, with or without a trainer/therapist. A successful training program only works with goal-oriented, long-term, consistent training. This is why we develop long-term plans that promote variation and consistency.

What makes the Functional Gait Performance Program so different?
Like everything else at Project Walk, this program isn’t based on traditional rehab or insurance guidelines; it is based on scientific sports performance training.  We treat every client at Project Walk as an athlete. Our clients set performance goals with very high expectations for themselves, and us. More importantly, our experience is second to none. We have been working successfully with SCI clients since 1999 and each year at our annual Steps to Recovery event, we have more clients participating and taking steps because of that success. 

How long are the workouts?
The workouts are as long as needed. Some clients workout for two or three hours while others do split training with morning and evening sessions where we focus on education and work load. Please understand that split training is only done for our short-term visitors; those spending a week or two with us. As your gait training coach, we will work with you to design a long-term program based on work load and recovery that you can consistently maintain at home.  

How fast can I expect results?
We don’t know. The severity of your gait problem and the length of time you’ve been compensating play a role in how long it will take to see results.  

How can I take the program home?  Don’t I need all that fancy, expensive equipment?
Our program is very simple. We don’t use fancy equipment for this stage of the program.  Our expensive, passive gait trainers are only used with clients that can’t move their legs. The equipment we use is people-friendly and can be found at any health club or purchased online. We keep it simple so you can be consistent.
                                           
Is there any help with the program once I leave?  Can I return for updates?
Yes to both. Ideally, you should visit occasionally for a re-evaluation and to make certain you are still going in the right direction. This should continue until you are completely satisfied with your walking gait.

What if I can’t return?
If you want to continue the program you will have access to a Specialist to help with questions and workout modifications. If you can’t come back, we recommend hiring a local trainer that you trust and we can teach how to work with you. Follow ups can be done with your Specialist via phone and internet conferencing.
       
Why do I need to modify my workout program?
You will adapt to the stimulus provided by the workout and once this happens, you will just be going through the motions. People that do the same workouts over and over see very little gains. Any successful workout program has to evolve as you change.

Is this a lifetime program?
Yes, this is a lifetime commitment. Once you are happy with your results it is up to you to be consistent with your training.

I have been told that I can’t improve my gait.
We have been studying and working with posture and functional gaits in able-bodied individuals since 1987. Almost every person that we have trained has had a muscle dysfunction where one side of the body was stronger/weaker than the other which ultimately leads to an imbalance. An example to illustrate this is a car being out of alignment--over time, the tires wear unevenly and rather than constantly replacing the tires, you fix the alignment. Unfortunately, when it comes to our bodies, we almost always look at the symptom and treat it. At Project Walk, we don’t focus on the fact that an individual has a spinal cord injury, we focus on the individual’s goals; evaluate their posture and gait; then formulate a plan to alleviate the weaknesses and bring about a more functional bilateral gait.

I can move my legs but was told that I will never improve to where I can walk.
Each injury ultimately determines how much function is returned. We can’t promise anything but the best method, the best program, the right stimulation and highly skilled, caring Specialists.   

Do braces help with a functional gait?
Braces do not help with a functional gait; they are for occupational purposes only. Braces eliminate gravity and load bearing forces. Without these fundamentals, muscles and nerves will atrophy. For example: someone breaks an arm and receives a cast for six to eight weeks---when the cast comes off, what’s happened to the muscles? They have atrophied.
                              
Does anti-spasm medication improve gait?
Spasms and tone are not the problem; they are only a symptom of an injured nervous system. If you treat the symptom, you will never recover. Treat the cause, and your nervous system will slowly reorganize into a more functional system.

I have a good leg and a leg that doesn’t work--any experience working with people like me?
Yes. This is one of the main reasons clients hire us to improve their gait. We have been very successful at training the weaker leg; from creating movement where none existed to improving deficient coordination. Almost every client we work with has a good and bad side. Our clients improve because we focus most of our attention on the weaknesses, not the strengths. With focused and efficient training, the gait can improve.

Details

The two types of gait trainers at Project Walk

• In-house -- clients who spend more than a month training at our center

• Home Program -- clients who visit for at least a week and continue their program at home, with or without a local trainer

Appointment Protocol for Your Week Visit 

Days One and Two   
We will evaluate your abilities and go over your individual goals; test your gait and standing postures, and film you performing a series of special movement patterns designed to reveal your weaknesses. Our program is based on this simple premise: identify the physical weakness and design a program to manipulate the weakness until it becomes a strength.  

We will educate you on your dysfunctions and discuss how we will proceed in order to change them. Education is the key to success. If you do not understand what you are doing and why, you will have trouble committing to the program. After reviewing your skills, we will begin to design a program around your structural and postural weaknesses that cause your compensations. The rest of the day is understanding, performing and perfecting your exercise routine.

If you bring your trainer, he/she will be with you every day. Your trainer will be taught how to work with you and your program. When you leave, both of you will have the knowledge to safely perform your workout at home.
                    
Days Three, Four and Five 
In addition to training for the five days, we have to pack a lot of education into a very short time. The goal of a week visit is workout design and teaching you and your trainer the proper technique for the desired drills. Without complete understanding of why and how, success will be less likely. During this first week, be prepared for a crash course in theory, anatomy, kinesiology, and biomechanics of the gait. We will go over the goals of the program and start to design a long-term program from the information gathered throughout the week.

Day Five 
In-House clients – During the last hour, we will review your first week and determine a plan for the upcoming weeks. Training days and hours will depend on your abilities and needs. You will have a Specialist who will supervise your workouts until you leave the program.

Home Program clients -- The last hour of your session you (and your trainer), will meet with your Specialist to review the week, answer any questions and finalize the long-term plan. Before you leave, we should have an understanding of how to work together so we may achieve your goals. Returning dates and goals should be finalized.

Follow-up Visits

Doing the same routine too long is ineffective training. Your body adapts to the stimulation and stops improving and you hit a plateau. You have to change your program as you improve. A new exercise program will be designed and implemented as your level of function changes. Clients should work with their Specialist to determine the best long-term plan for return visits and updates.

Maintenance Program

In-House clients:  Once you are able to do most of the workout program without any assistance, we will offer you a monthly gym membership. This membership allows you to use the center during the month at set appointment times and days. You will also spend one or two hours a month with your Specialist designing new programs for you to continue your progress.  

Home Program clients:  When you have reached your individual goal, it is time to design a program that will maintain that level of function. This routine has to fit your lifestyle so that you will do it consistently. If you do, you will maintain your function. Remember, maintaining is much easier than developing, so be consistent.