Physical Therapy Guide to Gait Dysfunctions
Gait dysfunctions are changes in your normal walking pattern. They often are related to a disease or problem in different areas of the body. Gait dysfunctions are among the most common causes of falls in older adults, accounting for about 17% of falls. This guide will help you better understand how gait dysfunctions are categorized. It also describes how treatment by a physical therapist can help you restore a healthy gait. Physical therapists are experts at identifying the causes of gait dysfunctions. They design personalized treatment programs to help people improve or restore their gait.
What Are Gait Dysfunctions?
Gait dysfunctions change the pattern of how you walk (your gait). Walking can require more effort and energy, and add stress to other parts of the body if you have a gait dysfunction. Some gait changes are related to an underlying medical condition, such as:
- Disorders involving the inner ear.
- Nervous system disorders such as Parkinson disease.
- Muscle diseases such as muscular dystrophy.
- Muscle, joint, or bone conditions or injuries
Types of gait dysfunction include:
Antalgic. This type of gait dysfunction is often caused by bearing weight on a painful leg. It can be related to arthritis or a traumatic injury and results in limping. People with this type take slow and short steps. They quickly try to shift their weight off the sore leg, ankle, or foot, and back onto the unaffected leg.
Ataxic. A person with ataxic gait has inconsistent and erratic foot placement. To compensate they may have a wide-based stance (feet wide apart). It is often seen in people with:
- A condition of the cerebellum (a region at the back of the brain).
- Multiple sclerosis.
- Some types of stroke.
- Conditions with a major loss of sensation (feeling) in the feet or legs.
- Drug or alcohol intoxication. This may result in a temporary gait impairment that resolves once the substance is eliminated. Physical therapists do not address this type.
Parkinsonian. This type is often related to Parkinson disease. It results in people taking short, shuffled steps. Difficulty starting or stopping walking can accompany this dysfunction.
Steppage. This type occurs in people with "foot drop" (when a person is unable to lift their foot from the ankle). The foot will "slap" the ground when stepping onto the foot. A person will need to lift the affected leg higher, so the toe clears the ground when walking. Steppage is linked to conditions such as:
- Lumbar radiculopathy (a range of symptoms produce by a pinched or compressed nerve in the spine).
- Neuropathy (damage or loss of function in nerves causing numbness, muscle weakness or pain, often in the hands or feet).
- Muscle weakness related to stroke.
Vestibular unsteadiness. This pattern causes people to walk unsteadily, often falling toward one side. It is often linked to:
-
Vertigo.
- Meniere’s disease (an inner ear condition).
- Labyrinthitis (a type of inner ear disorder in one ear).
Waddling. People with this type of dysfunction may walk on their toes, and sway side to side. It often arises from conditions such as:
-
Muscular dystrophy.
- Myopathy (muscular diseases).
- Marked weakness of the large muscles of the hip and thigh.
Slow gait. This type of gait pattern is an overall slow speed of walking. It is often associated with:
- Age-related changes.
- Fear of falling; cautious walking.
Note: These are only a few of the many possible gait dysfunctions. If you suspect you are walking differently, contact a physical therapist for a gait assessment.
How Can a Physical Therapist Help?
Physical therapists play a vital role in helping people improve their gait. Your physical therapist will work with you to address your specific needs and goals. They will design a personalized program to treat your specific condition.
Your physical therapy treatment plan may include:
Pre-gait training. Your physical therapist may begin your treatment by helping you understand how to improve your gait before you take a single step. Pre-gait exercises may include:
- Standing in place.
- Shifting your weight from one leg to the other.
- Moving your leg in stepping patterns that encourage the positions and muscle patterns used for good walking.
Gait training. Your physical therapist will help you focus on retraining how you walk. They may vary your training based on whether your underlying condition is:
- Vestibular (inner ear related).
- Neurological (brain or nerve related).
- Muscular.
Your physical therapist will design the safest and best program for your specific condition.
Balance and coordination training. Your physical therapist may prescribe balance activities and exercises to help with stability during walking.
Neuromuscular reeducation. Your physical therapist may use techniques to stimulate inactive muscle groups. They will work with you to retrain the timing, coordination, and activation of the muscles you use for walking.
Bracing or splinting. If your gait problem is due to substantial weakness or paralysis, your physical therapist may teach you how to use adaptive equipment, like a brace or splint, to help you move.
Can This Injury or Condition Be Prevented?
Gait dysfunctions are related to many different types of underlying conditions. You may not be able to prevent some types. However, if addressed and treated early, many gait dysfunctions can be improved. Improving your gait can help you avoid additional problems, such as:
- Falls.
- Stresses on joints and ligaments.
- Fatigue in daily activities.
** from choosept.com
