Tell us about the courses. How does higher-level mobility analysis assist with retraining after neurological injury?

Higher levels of mobility are important for participation in day-to-day activities but rehabilitation has traditionally focused on things that are important for leaving hospital and living independently, such as the ability to transfer and walk.

Higher-level mobility analysis is not typically taught at an undergraduate level, so clinicians may not necessarily be confident about analysing running and other high-level activities.

Most neurological clinicians are experienced, however, in the analysis and treatment of gait; these courses just take our analysis and treatment to another level.

What are the main differences between the paediatric and adult versions of this program?

The similarities between the courses far outnumber the differences.

The biomechanics of and muscle function for running are what they are.

So, to a certain extent, regardless of what the diagnosis is and whatever the clinical presentation may be, we know where the intervention is headed.

However, there may be some additional considerations for people with conditions outside of typical development, such as cerebral palsy.

Many people with adult-onset conditions such as stroke and brain injury have known more typical movement and have an understanding of what they aim to achieve.

What is an impairment-focused approach to gait analysis?

Severe and complex gait and running disorders can be overwhelming.

When working in this field, we analyse gait and running first and determine what the abnormal movements are.

Then we identify the associated physical impairments (eg, weakness, spasticity and contracture) that may contribute to those observations.

This makes our interventions more specific and effective.

It also helps prioritise treatment and enables targeting of the primary biomechanical abnormalities and associated physical impairments rather than secondary associated features.

What led to the development of these courses?

We started our running program more than 25 years ago.

We found that although 98 per cent of our patients achieved independent walking, over 70 per cent were not returning to their pre-accident activities.

In many cases, the skills required to participate in social, leisure and sporting activities rely on higher levels of mobility such as running and agility.

We set up a research program aligned to our clinical program to investigate what we do, why we do it and what we need to do better.

Excitingly, we have a team of paediatric clinician researchers, including Noula Gibson, Annie Chappell, Tanja Spencer, Anne Kissane and Gaela Kilgour, who are advancing this field for kids.

What do you hope participants will take away from these courses?

We need more clinicians to be comfortable with the process of assessing and treating higher-level mobility limitations, to know when it’s appropriate to start and how to go about it, to have strategies to ensure that their patients are safe and not likely to fall, and to know when to introduce agility and sport-specific exercises.

The resumption of activity after concussion has received an enormous amount of attention, but this has not been the case for more severe types of brain injury and other neurological conditions—we need to change that.

‘Adult gait and running analysis and retraining’ and ‘Paediatric gait and running analysis and retraining’ will run 4–5 March in Queensland and 18–19 March in Bruce, Australian Capital Territory. Click here, here and here for more information and to register.

>> Professor Gavin Williams FACP has worked in neurological rehabilitation for 30 years. He is the Professor of Physiotherapy Rehabilitation, a joint position appointed between Epworth HealthCare and the University of Melbourne. Gavin was awarded Fellowship of the Australian College of Physiotherapists in 2010.