Overview and Facts about Gait Disorders
Gait disorders are abnormalities in a person’s manner of walking. A human’s gait depends on a complex interplay of parts of the nervous, musculoskeletal, and cardiorespiratory systems that allows a person to walk with a normal gait.
Gait disorders are particularly prevalent in the elderly and increase fall risk. The causes of gait disorders include neurological conditions, orthopaedic problems, and medical conditions. Some of the different types of gait abnormalities include:
- Hemiplegic gait
- Diplegic gait
- Neuropathic gait
- Myopathic gait
- Ataxic gait
- Parkinsonian gait
Signs and Symptoms of Gait Disorders
The signs of a gait disorder depend on the specific type.
- Hemiplegic gait: affects one side of the body; when walking, the patient will hold his or her arm to one side and drag the affected leg in a semicircle (circumduction)
- Diplegic gait: characterized by bent hips and knees with the ankles internally rotated, resulting in a swinging gait on both sides of the body
- Neuropathic gait: seen in patients with foot drop, resulting in the person stepping higher than normal in order to prevent the toes from scraping the ground when walking
- Myopathic gait: characterized by a person waddling from side to side when walking due to weakness in the pelvic region
- Ataxic gait: characterized by staggering movements when walking; when a person is standing still, they will have a wide stance and unsteadiness in the trunk of the body (titubation)
- Parkinsonian gait: an individual will have a stooped posture, with the head and neck bent forward; they have difficulty initiating steps, and they walk with slow, little steps
Causes and Risk Factors of Gait Disorders
Problems with an individuals gait are often caused by an underlying condition or disease, such as multiple sclerosis, Parkinson’s disease, stroke, muscle disease (myopathy), brain or head trauma, congenital hip dysplasia, and joint pain or conditions (such as arthritis). Causes of the different types of gait disorders include:
- Hemiplegic gait: Stroke
- Diplegic gait: Cerebral palsy, stroke, or brain or head trauma
- Neuropathic gait: Multiple sclerosis, amyotrophic lateral sclerosis, or other peripheral neuropathies
- Myopathic gait: Muscular dystrophy, muscle disease (myopathy), or spinal muscle atrophy
- Ataxic gait: Brain injury, damage to nerve cells in the cerebellum of the brain, certain seizure medications, brain injury, or alcohol intoxication
- Parkinsonian gait: Parkinson’s disease or side effects from certain drugs
Tests and Diagnosis of Gait Disorders
A diagnosis is made by a neurologist, a specialist in neurology (movement disorders), and is based on a patient’s medical history and a physical exam. The exam will include muscle, bone, and nervous system evaluation, along with observation of the patient’s gait. The neurologist will decide if further tests are necessary, based on the results of the physical exam.
Treatment and Care for Gait Disorders
Treatment depends on the underlying cause. Gait disorders may respond to targeted medical or surgical interventions. Other options for patients with gait disorders include exercise and physical therapy to improve strength, balance, flexibility, or endurance. Reduction in the number of medications or removing medications causing adverse effects can also improve gait disorders and reduce the risk of falling.