1. Normal and Pathological Gait in the Elderly Peggy R. Trueblood, PhD, PT California State University, Fresno

2. Part III Gait Pattern Variation and Enhancement Training

3. FUNCTIONAL LEVEL TRAINING  Activities to challenge client to modify or adapt walking pattern to environment

4. Task Demands Environment Individual Capabilities Surface Type Visual Flow Seated Standing Moving Single Multiple Strength ROM Sensory Loss Cognition Lighting

5. GOAL is to maximize the challenge, minimizing the risk.

6. Consider activities that will challenge:  Timing demands  Spatial demands  Flexibility/Adaptability

7. Progression Variables  Change Environmental Demands Support Surface  Uneven  Compliant

8. Inclines Raised surfaces Moving surfaces

9. Narrow surface

10. Visual Environment  Head Turning  Focusing on object  Busy environment  Moving environment

11. Progression Variables  Change Task Base of Support

12. Gait Pattern  Crossover  Braiding  Side Step  Backwards

13.  Change Demand of Task Start/stop on command Directional changes on command Pacing of commands (faster pacing more demanding)

14.  Stepping over obstacles of various heights  Stepping around obstacles  Stepping on obstacles

15.  Increase Number of Tasks  Walking with head turns  Various obstacles to maneuver within an obstacle course

16. Carrying object while walking through obstacle course Add cognitive task