What is a gait disorder?
Gait is a person’s pattern of walking. Walking involves balance and coordination of muscles so that the body is propelled forward in a rhythm, called the stride. There are numerous possibilities that may cause an abnormal gait. Some common causes are:
- A degenerative disease (such as arthritis)
- An inner ear disorder
- Foot conditions
- A neurologic condition
- Something as simple as ill-fitting shoes
What are some types of gait disorders?
The following gait disorders are so distinctive as to earn names:
- Propulsive gait. This type of gait is seen in patients with parkinsonism. It is characterized by a stooping, rigid posture, and the head and neck are bent forward. Steps tend to become faster and shorter.
- Scissors gait. This type of gait gets its name because the knees and thighs hit or cross in a scissors-like pattern when walking. The legs, hips, and pelvis become flexed, making the person appear as though he or she is crouching. The steps are slow and small. This type of gait occurs often in patients with spastic cerebral palsy.
- Spastic gait. Common to patients with cerebral palsy or multiple sclerosis, spastic gait is a way of walking in which one leg is stiff and drags in a semicircular motion on the side most affected by long-term muscle contraction.
- Steppage gait. A “high stepping” type of gait in which the leg is lifted high, the foot drops (appearing floppy), and the toes points downward, scraping the ground, when walking. Peroneal muscle atrophy or peroneal nerve injury, as with a spinal problem (such as spinal stenosis or herniated disc), can cause this type of gait.
- Waddling gait. Movement of the trunk is exaggerated to produce a waddling, duck-like walk. Progressive muscular dystrophy or hip dislocation present from birth can produce a waddling gait.
Who is at risk for a gait disorder?
The chance of a gait disorder increases with age, as older people tend to experience more conditions that cause an abnormal gait and typically have weaker muscles, delayed reaction and less muscle coordination than younger people.
How can your doctor tell what is causing your gait disorder?
The cause of a gait disorder can be multiple and sometimes the causes overlap. To diagnose the disorder, the doctor will first observe your gait. Next,
- He or she may check that the legs are the same length (some patients with artificial hips or lower back pain may have legs of different length).
- Your muscle strength, muscle tone, and coordination will be assessed.
- If you are older, your vision and blood pressure (both lying and standing) may be checked to rule out vision problems or orthostatic hypotension (low blood pressure upon standing) as the cause.
- Your neck and spine may be checked for deformities.
- An assessment of your risk of falling will be performed.
- Depending on the type of gait disorder, you will be checked for arthritis or neurologic disorders such as Parkinson’s disease.
Based on these results, laboratory and imaging studies may be done.
Care and Treatment
What can be done to improve a gait disorder?
It depends on the cause. Assistive devices such as canes and walkers may help in some cases in which balance is a problem. Physical therapy and strengthening exercises may be appropriate in other cases to improve balance, strength and flexibility. You should also receive instruction in fall prevention.
Maintaining proper foot alignment may require in-shoe splints or leg braces. A shoe lift may help in cases of an unequal leg length.
Treating the underlying cause of the abnormal gait may help you recover some function. Medicines are available to treat arthritis, Parkinson’s disease and multiple sclerosis. Surgery or prostheses may be recommended, such as hip and knee replacement for persons with osteoarthritis.