Gait disturbances can be associated with both congenital conditions and appear in the course of life. Walking problems range from excessive side-to-side swaying and unsteadily walking with your legs wide apart. What are the causes and types of gait disturbance? How is the treatment going?

Gait disturbancecan appear in everyone - such problems can be experienced by both children and the elderly. There are at least several types of gait disturbances, in addition, problems with walking, occurring in different patients, may be both temporary and persistent ailments.

Gait disturbance: causes

Gait disorders are of interest to doctors of many different speci alties, but this issue is mainly de alt with by neurologists, orthopedists and paediatricians. The fact that the problem is de alt with by a large number of specialists is due to the fact that pathologies concerning both the activities of the nervous system and bone, muscle and joint structures can lead to gait disturbances. There are many potential causes of gait disturbances, examples of which may be:

  • Parkinson's disease
  • multiple sclerosis
  • muscular dystrophy
  • inflammation of tendons or joints in the lower limbs
  • stroke and its consequences
  • conditions after lower limb fractures
  • osteoarthritis
  • inner ear infections where the labyrinth is affected by the disease
  • cerebral palsy
  • ponytail syndrome
  • Charcot-Marie-Tooth disease
  • normotensive hydrocephalus (Hakim's syndrome)
  • dementia (e.g. Alzheimer's disease)
  • myasthenia gravis
  • cancer oun
  • episodes of transient cerebral ischemia (TIA)
  • concussion
  • peripheral vascular diseases of the lower extremities
  • encephalitis
  • Wernicke-Korsakoff syndrome
  • prion diseases
  • pernicious anemia
  • mental disorders and diseases (gait disturbances may appear especially in the course of conversion disorders)

Gait disturbance: types

Some specialists distinguish more, others less types of gait disorders. Most often you can find the followingtypes of walking problems.

  • Mowing walk

Mowing gait (or hemi-paresis gait) is defined as the condition in which the patient has a straight leg in the knee joint. While walking, patients make a semicircle with their occupied leg, which resembles the movement of a scythe while mowing hay. This is usually accompanied by the flexion of the forearm at the elbow joint. The mowing gait occurs in the case of hemiplegia, which may be caused, for example, by a stroke.

  • Rooster walk

Another problem is the cock (wading) gait. It occurs as a result of paralysis of the extensor muscles of the foot and fingers (e.g. due to damage to the peroneal nerve). In patients, foot drop is noticeable, and in addition, in the rooster walk, patients raise their lower limbs high.

  • Atactic gait

The back lacing (atactic) gait means that the patient's steps are very unsteady and his steps are extremely uneven. Characteristic of this type of gait disturbance is that patients try to look at their legs while walking - this is due to the fact that they experience proprioceptive sensory disturbances, which make them unaware of the position of their limbs. When the gait is not subject to visual control, atactic gait exacerbates the existing abnormalities. In this problem, the deviation is noticeable not only when moving - patients may also find it difficult to maintain a standing posture with their feet together with their eyes closed. The conditions in which the functions of the posterior cords of the spinal cord are disturbed are brought about to the posterior cords gait.

  • Cerebellar gait

Unstable walking with widely spaced lower limbs is referred to as cerebellar (sailor) gait. As the name suggests, it is caused by disorders of the cerebellum (e.g. tumors of this structure). In this case, the gait disturbances are accompanied by posture disturbances, depending on the location of the defect in the cerebellum. When the cerebellar worm is damaged, the patient's torso is tilted back. Another condition, i.e. the tendency to fall towards damage, is noticeable in patients with damaged cerebellar hemisphere.

  • Parkinson's walk

Parkinson's (hypokinetic) gait is seen in people with Parkinson's disease. In the case of this type of gait disturbance, patients have an inclined posture while moving, it is also characteristic that their upper limbs (unlike in he althy people) do not balance while walking.In parkinsonian gait, the patient moves very slowly and in small steps, and in the course of this problem there are also difficulties in initiating movement of the lower limbs. A significant problem with this gait disorder is an increased risk of falls.

  • Duck gait

Duck-like gait is quite a characteristic gait disturbance. In the course of this problem, patients noticeably wobble from side to side. Pathologies leading to this disorder are conditions in which there is a dysfunction of the muscles of the hip girdle, such as dislocation of the hip joints or muscular dystrophy.

  • Scissor walk

Scissor gait is a problem in which the patient involuntarily crosses his limbs while walking. Cerebral palsy may be the cause of scissor gait.

  • Chód pląsawiczy

Chore gait is used to describe problems associated with involuntary chorea. Patients' movement may be dance-like, and lower extremity disorders are usually accompanied by movement problems with other parts of the body. For example, Huntington's disease can lead to chorea.

  • Paraparetic gait

Paraparetic gait may be flaccid or spastic. In the first of these problems, patients experience paresis of the lower limbs, and they often experience falls. In the case of the spastic form of paraparetic gait, patients place their lower limbs extremely stiffly, and they may also experience shuffling with their feet on the ground.

  • Hysterical gait

There are also situations in which the patient's gait disturbances are very nonspecific, in addition, the patient's problems with movement may change their nature over time. This is the case with gait disturbances associated with mental disorders, which are sometimes referred to as hysterical gait. In their course, patients may present atypical movements that cannot be attributed to any of the gait disturbances mentioned above. The reasons for such problems may be, among others conversion disorder.

Gait disturbance: diagnosis

In the event of a gait disturbance, two aspects are important: the lower limbs of the patient should be examined, but it is also very important to conduct a thorough medical interview with him. In the case of examining the lower limbs, it is necessary to assess the mobility of individual joints, as well as to check aspects such as skin sensation or intensity.tendon reflexes (both physiological and possible pathological).

Medical history (subjective examination) is very important because it enables the diagnosis of gait disorders to be directed towards a specific disease entity. On the basis of the information obtained, patients can be referred, for example, to imaging studies of the structures of the central nervous system (e.g. in the case of a suspected stroke or multiple sclerosis development). Other patients, who in turn are suspected of having problems directly related to the lower limbs, may be referred for imaging examinations of the musculoskeletal structures.

Gait disturbance: treatment

Recognizing the cause of a patient's gait disturbance is important primarily because it may be possible to eliminate mobility problems by treating the individual who led to this condition. For example, patients with Wernicke-Korsakoff syndrome may be administered vitamin B1preparations, and patients with multiple sclerosis may be administered drugs that alleviate disease relapses (i.e. Gait disturbance may be transient but, in some patients, persistent. In the latter situation, regular rehabilitation can bring invaluable help to the sick. Sometimes it is also beneficial for patients to use equipment that facilitates movement, e.g. orthopedic crutches or the so-called walkers (walkers).

Category:

Neurology