You may require rehabilitation to learn to move muscles, to compensate for a lack of balance, and to learn how to prevent falls. For vertigo-caused balance issues, you may learn how to position your head to regain balance. For older adults, gait and balance problems can cause you to fall. This can lead to injury, loss of independence, and a change in lifestyle. In some cases, falls can be fatal.
There are a wide variety of treatments for all issues. Uncoordinated movement may be a sign of disrupted communication between the brain and body. Learn more about this condition and how to treat it. Learn to recognize the symptoms of a duck-footed gait, what causes it, and how to treat it at home or with medical approaches for severe cases.
Do you walk with a limp to avoid putting pressure on an area for fear of pain? This is referred to as walking with an antalgic gait.
We'll let you…. A waddling gait refers to an unusual walking motion. Learn whether this is normal among pregnant women, children, and adults. Titubation is a type of involuntary tremor that occurs in the head, neck, and trunk area. Obe Fitness is an online platform offering thousands of on-demand workouts and 20 live classes each day. After trying Obe Fitness for 30 days, we're…. Sustainable fashion involves producing clothing in an ethical and environmentally conscious way.
This is conducted with subjective and objective tests during routine follow-up visits, typically upwards of months after surgery. Ataxic gait refers to a staggering gait, with variability of the step timing and distance between the steps. Ataxic gait disorders occur due to dysfunction of the cerebellum, the part of the brain that is responsible for coordination of movements. Typical causes of cerebellar ataxia include strokes in the cerebellum, alcohol intoxication or chronic alcohol abuse, and multiple system atrophy — cerebellar type MSA-C.
Multiple sclerosis MS can also cause cerebellar ataxia when there are lesions in the cerebellum. Family history may not reveal any patterns, especially in a small family, even though the cause is genetic. Other clinical signs and symptoms may point to a specific spinocerebellar ataxia syndrome, e. Diagnostic tests include MRI of the brain, blood work, DaTscan if there are signs of parkinsonism, genetic testing, and sometimes nerve conduction studies.
Treatment depends on the underlying cause but typically involves physical therapy and avoidance of alcohol intake. Unfortunately there are no medications that boost the balance or cerebellar function. After a fall or near-fall, patients often modify their gait patterns for fear of falling, resulting in what is called cautious gait.
If you imagine a person walking on ice, you can get a good picture of a cautious gait: legs are further apart, stiff-legged, slow, feet kept closer to the ground, arms held out with reduced arm swing. Patients with cautious gait disorders improve greatly with physical therapy and balance training. They have physical therapists who specialize in gait and balance improvement, utilizing the latest technologies including the Alter-G treadmill.
This technique allows patients to improve their gait pattern in a reduced-gravity setting, eliminating the risk of falls. Pelvic girdle weakness can cause a waddling gait.
Pregnant women often have a waddling gait due to stretching of the pelvis. Compression of the nerve or nerve root peroneal neuropathy or lumbar radiculopathy, respectively that gives information to the anterior calf muscle can cause weakness in elevating the foot, causing foot drop. This may manifest as a steppage gait where the patient tries to compensate for the foot drop by lifting the leg higher at the level of the hip.
Treatment for these conditions depends on the underlying cause. Some causes of myopathy are treated with immunosuppressant medication; some causes of nerve or nerve root compression require surgical decompression.
Physical therapy for foot drop may include nerve or muscle stimulation, depending on the cause. The use of an ankle-foot orthotic foot brace helps patients minimize the risk of falls from foot drop.
Regardless of cause, the mainstay of treatment for gait disorders caused by nerve or muscle disorders involves physical therapy with a strengthening and conditioning program.
Problems in the spinal cord or brain can cause the muscles to be too tight and not relaxed enough, resulting in a stiff-legged or cross-legged gait known as a spastic or scissoring gait. Spasticity most commonly occurs after a stroke, where it typically affects one half of the body. Spasticity can also affect both legs in the case of multiple sclerosis MS , or metabolic or degenerative causes of spinal cord disease. Treatment for spastic gait includes anti-spasmodic medications such as baclofen, tizanidine Xanaflex , cyclobenzaprine Flexeril and carisoprodol Soma.
However, these medications often cause drowsiness, dizziness and muscle weakness. Injection of botulinum toxin Botox or Xeomin can significantly reduce muscle overactivity without causing any sedation. By relaxing tight muscles, botulinum toxin injections result in a smoother gait and less spasm in the feet, legs or thighs. At Pacific Movement Disorders Center, we provide EMG-guided botulinum toxin injections to target the most overactive muscles of the legs. Injections take about minutes and are repeated times per year.
Conditions affecting the inner ear cause trouble with equilibrium and symptoms of room spinning, known as vertigo. The bradykinesia and slowness of postural adjustments, together with a forward-flexed posture, produce the 'festinant gait' typical of Parkinson's disease. Parkinsonian gait has several features, including:. This describes a combination of findings seen in patients with cerebral tumours, subdural haematomas, dementing illness, normal pressure hydrocephalus, and multiple lacunar infarcts.
Characteristic findings are:. Motor function of the legs is sometimes much better when seated or lying, suggesting an element of gait apraxia. Some of these findings resemble Parkinsonism, but the distinguishing features of frontal gait disorder are its wide base, normal arm swing, absence of other Parkinsonian features, more upright posture, and higher incidence of dementia and urinary incontinence.
Causes include frontotemporal dementia , frontal lobe degeneration and normal pressure hydrocephalus. This indicates pyramidal pathway damage - and the residual power left is dependent on non-pyramidal pathways and there being enough residual cortical function.
Damage to the descending corticospinal tract eg, by a tumour may present initially with a generalised stiffening of the legs. The patient may find it impossible to walk quickly or run. Features are:. Scissor gait is usually seen in spastic cerebral palsy , usually diplegic and paraplegic varieties. Characteristic features include:. These features are typical and are usually present to some degree regardless of the mildness or severity of the cerebral palsy.
Many patients respond well to a simple home programme of vestibular rehabilitation head movement exercises. This results in reduced symptoms of imbalance during stance and gait. The gluteus medius is very important during the stance phase of the gait cycle to maintain both hips at the same level. During the stance phase of the gait cycle, there is approximately three times the body weight transmitted to the hip joint.
The hip abductors' action accounts for two thirds of that body weight. A Trendelenberg gait is the result:. Trendelenburg gait is also seen in L5 radiculopathy and after poliomyelitis, in which case there is usually also a foot drop.
Strain to the gluteus maximus and gluteus minimus can be caused by overuse of the gluteus medius by sportsmen using glute-isolating equipment. Tendonitis or tears of the gluteus medius can occur after sports injury or with long-term wear and tear.
These tears generally cause pain and weakness on the side of the hip not the groin. The role of the gluteus medius during activities such as walking and running is to dynamically stabilise the pelvis in a neutral position during single leg stance.
The muscle tear itself may be relatively painless, and athletic patients are often masters of compensation and able to keep the pelvis in neutral while the lower leg adducts and internally rotates, making diagnosis tricky. Ultrasound may be helpful for diagnosis.
Typically unsteady, gait in neuropathic disorders is often high-stepping, this being an almost diagnostic feature. Patients may fall over if asked to close their eyes. In vascular dementia there is early disturbance in gait, with unsteadiness and frequent, unprovoked falls. Early in the condition this is typically more marked than in Azheimer's disease.
There may be focal neurological abnormalities such as visual disturbances eg, field defects , sensory or motor symptoms eg, dysphasia, hemiparesis, visual field defects or extrapyramidal signs eg, dystonias and Parkinsonian features. Cautious gait is seen in early Alzheimer's disease. Changes to gait may be subtle at first, presenting initially with a reduction in the speed and stride of walking.
Balance disturbance, short-stepping gait and apraxia increase with the severity of disease. Frontal gait disorder is also more common in Alzheimer's disease patients.
The degree of impairment is associated with factors related to the severity of the disease low Mini Mental State Examination MMSE and low Activities of Daily Living ADL scores , but also to factors such as age, sex, depression, obesity, and the presence of comorbidities [ 7 ].
In psychiatry, gait disturbances reflecting cortical and subcortical dysfunction are often seen. Specific examples include:.
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