A very valuable exercise and motor control intervention for gait training that I never see or hear utilized is Rolling. Yes, Rolling is used for motor control deficits, but its utilizations are broader than just the SFMA. Rolling is fundamental to gait and can retrain several motor pathways/circuits needed for proper gait technique. Your sure to see good carryover in gait kinematics after Rolling has been properly integrated for several reasons:
- Rolling “turns on” several circuit breakers that are needed for ambulation. These motor control pathways that include core engagement and segmental stability may be difficult to properly engage with other gait training techniques or positions.
- Rolling is fundamental in the neurodevelopmental process and proceeds crawling and walking. Your body initially used Rolling to aid in preparing for walking when you were an infant. Therefore, utilizing rolling is likely a very effective tool to retrain it again.
- Rollling is reciprocal. Meaning one leg flexes and rotates while the contralateral limb is extending and stabilizing. This is exactly the swing and stance phase for gait, just exaggerated. These exaggerated movements can aid in proper motor learning.
- Rolling segmental engages the pelvis and lower limbs while integrating it with trunk rotation. Often this is a large problem with gait; leading to improper sequencing and poor coordination. Rolling is a large proprioceptive drill that can improve these.
- Rolling can improve symmetry. Asymmetries lead to poor weight acceptance and poor single limb stability deficits. Starting with rolling can improve symmetry and make it easier to accept weight and be stable on the stance limb.
- Rolling teaches the body to use proper arm swing. By training Rolling with UE dominant patterns the patient can retrain the shoulders and thoracic chain to engage with the trunk; necessary for reciprocal arm swing and normal forward propulsion.
Add UE dominant and LE dominant Rolling patterns with the proper pattern assist, cueing, and progression and be ready to reap the benefits of quickly improved gait mechanics.
