Walking; what a gift!

As part of my neurorehab rotation, I experienced first-hand two techniques for gait-training. They are both research tools currently but have showed promising results to help people with hemiplegia and SCI (spinal cord injury) walk and walk better.
I had only seen a few pictures of what I was going to experience. The first equipment I was hooked up to was a gait-robot called the “Lokomat”. By hooked up, I literally mean hooked up! The machine comprises of a treadmill, three different computer systems, works on electricity, has weight suspensions and sockets which house straps for your ankles, knees and hips and the machine fits snugly on your pelvis to stabilize it. The process of taking the first step involves a lot of preparation. There are all these measurements which must be taken before one can actually work on the robot. There’s a lot of trial and error before the right fit can be established. As Mr. L, the very patient therapist and researcher was going over the fitting process which took a good 45 mins, he explained how since patients are usually hemiparetic/ paraparetic, they could easily tire out before the measurements are completed and that might be the end of their session! It might even take a few sessions just to get the fit right! One of the motor-learning principles which seems difficult to achieve is to be to get a movement as close to normal is one of the principles the robot works on. The way the robot works is by making your joints moved in a co-ordinated fashion to mimic normal gait and with training, the amount of work done by the machine is decreased and the amount done by the patient is increased. Walking is not really about strength but about co-ordination and hence, there’s enough hope and means to make people who do not have 5/5 power in their lower extremities walk normally.
Getting on to the treadmill with all the gear as if I was about to sky-dive was almost surreal. So, once you're on the robot, you are actually suspended in air by way of weights. As I "stood" suspended in mid-air, I almost felt like a super-hero! Not until, the robot actually started moving my legs, did I realize that this was for real. Mr. L would keep checking if I was comfortable or not or if something didn't feel right. I was trying to tell the difference between the robot-generated gait and my normal walk. The weird thing is that besides having attended a brilliant anatomy lecture on gait by Dr. SRK in my first year of medical school, I hadn’t really thought about walking and so, understanding the subtle differences was quite difficult! To think that so much of evolution got us from a quadripedal gait to a bipedal gait only seems fair when you admire the complexity and the number of muscles involved in making sure you get to your destination whether it's Mt. Everest, the moon or your refrigerator! Walking is just one of those things we take for granted, which we never think consciously about unless we are in pain. It's an amazing feat of co-ordination, endurance and almost beautiful when you think about the principles! Perhaps, today was yet another reminder to not forget to be grateful for all things we take for granted. I was almost ashamed to think of the times I've complained about walking or taken the easier way out by driving or hailing a cab! It's a gift we use every single day and what a thoughtful gift it is! Kudos to researchers and therapists trying so hard to give this simple, elegant gift back to patients who will only feel so much more independent once they can stand up on their feet again.