Gait dysfunction, What is it?
Walking difficulty / Gait dysfunction, you just just learned the clinical term for a common description. Gait disturbance means there is a change in a person’s walking pattern. These changes are typically related to some type of medical condition, such as dizziness, weakness, or a neurological condition, but those are not the only ones that can contribute to gait abnormality. Gait dysfunction, also called gait disturbance, can be serious as it is the most common reason for a person to fall.
Walking is an activity that uses a complex integration of systems that must come together to perform well. Walking uses the ears, eyes, brain, muscles, and nerves, and all areas need to come together at the right time.
Gait disturbance is classified many ways, and the following six patterns are among the most common:
- Antalgic Gait– This is used to describe walking that is affected by a painful area, likely in the lower extremities or sometimes the lower back. The gait pattern has slow, short steps with quick weight shifting. In layperson’s terms, this is known as “limping.”
- Cerebellar Ataxia– This occurs with those who have a condition affecting of the part of the brain called the cerebellum. A lot of coordination of balance happens in this part of the brain. This pattern can result from a stroke, multiple sclerosis, or alcohol or drug intoxication. The gait is described as having a wide stance with inconsistent foot placement.
- Parkinsonian Gait- A short, shuffling pattern, also called “festinating,” is typical of patients who have been diagnosed with Parkinson’s Disease. Patients will often also demonstrate a forward flexed trunk.
- Steppage Gait- Most often, this pattern is seen with those who suffer from foot drop caused by a low back or neurological disorder causing weakness in the foot and ankle. Patients with this pattern lift the hip and knee higher to clear the foot when advancing the leg.
- Vestibular Ataxia-Those who suffer from inner ear conditions (vertigo, Meniere’s Disease, or labyrinthitis) will show this pattern. This will appear as an unsteady walk and patients will often seem to be leaning or falling toward one side.
- Waddling Gait- This pattern will be seen in those who have been diagnosed with muscular dystrophy or myopathy (a muscle disease causing weakness). Walking on toes and swaying side-to-side are most frequently seen with this category.
What causes gait dysfunction?
The coordination of walking is impacted by all the different systems in the body. The musculoskeletal system, nervous system, and cardiovascular system all work together to keep a person moving and on his or her feet. If any one of those areas are impaired, a person’s gait can be affected.
Whether the gait disturbance is caused by an injury, trauma, pain, or an underlying medical condition, if it continues, it becomes more likely to impact other aspects of the patient’s life and health.
For example, someone may suffer from right knee arthritis which is causing antalgic gait. Over time, if the right knee condition is not managed, the gait changes caused by the condition will begin to not only irritate the right knee, but can also impact the foot, ankle, hip, lower back, and left side.
A person with dizziness, an inner ear condition, or a neurological condition has a higher risk of falling, due to the unsteady pattern and issues with imbalance.
How is gait dysfunction diagnosed?
The first thing to understand is what is causing the change in the walking pattern. Physical therapists work closely with all members of the patient’s medical team to provide a well-rounded approach to care, so if a patient has specialty services and multiple medical providers involved, the PT will be in communication with the other team members.
Physical therapists are skilled in gait analysis and appropriate special testing to help determine the factors that are likely causing and contributing to the gait dysfunction. PT’s perform comprehensive evaluations, which include discussing and understanding the patient’s medical and social history, testing for fall risk, mobility, balance, coordination, strength, flexibility, and all other areas that can impact gait and ambulation.
Treatment of Gait dysfunction
Based on the findings during a patient evaluation, the PT will develop a treatment plan to address the factors that are affecting the patient’s gait. They create a plan specific to each patient’s conditions and goals. The comprehensive plan will include treatment to address any issues with balance, strength, flexibility, coordination, and if needed, instruction in the use of an assistive device like a cane or walker. Exercises are progressed and supervised with the patient’s safety as a top priority and all treatment strategies are individualized to each patient’s needs and goals.
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