Getting from one place to another, or locomotion, is an important aspect of daily living. Locomotion can be accomplished in a variety of ways. Terminology associated with pedal locomotion includes the following:
Gait—the process of moving on foot (e.g., walking, jogging, or running).
Walking—a form of gait in which one foot is in contact with a surface at all times and in which there is a period of double-limb support.
Ambulation—a term commonly used in rehabilitation to denote walking with or without an assistive device and with or without physical assistance from another person.
Running—a form of gait characterized by a “float period,” during which neither foot is in contact with the ground surface.
In the following chapters we explore different ways of moving—with wheels and with assistive gait devices—and the principles that make these activities safe and effective. To be effective, mobility must be controlled. (Falling and rolling unstoppably down a hill in a wheelchair are both forward motions, but they are far from desirable activities.) Controlled mobility is predicated on a person’s capacity for mobility (e.g., adequate range of motion and muscle innervation) and on static stability (the ability to maintain a still position; see Fig. 1).
Controlled mobility is predicated on a patient’s capacity for mobility and on static stability.
Whether locomotion is accomplished in standing or in sitting, applying simple motor learning principles, communication, and biomechanical guidelines will facilitate the process. The human body is designed to function most efficiently when its parts are working together, doing what they were designed to do—the pattern we call “normal” or “typical” movement. But all of us have conditions or habits that can cause us to move less than optimally. If those conditions are extensive enough, we may need assistive devices and equipment to help us achieve our mobility goals.
In many cases, skilled training with the use of an assistive device can enable a patient with restrictions in body structures or functions to walk. In other situations, ambulation either is not possible or cannot be completed safely, efficiently, or effectively. When a patient is unable to walk or lacks the endurance necessary to ambulate functional distances, a wheelchair can increase a patient’s functional ability. If, for example, a person is able to walk only 15 ft (4.6 m) at a time using a walker but needs to cover greater distances more quickly as a courtroom lawyer, a wheelchair may provide that person with higher levels of participation and a better quality of life.
Locomotion can also be used as a form of exercise, but locomotion for the purposes of social interaction and engagement with the environment should always be made as easy as possible. Making the primary means of locomotion difficult for the ...