Gait Dysfunctions

Walking is one activity many people do not even think twice about and is considered a natural part of life. Nevertheless, a simple walk can be problematic for many people because of specific gait dysfunctions.

These gait issues impair a patient's mobility and quality of gait. Dysfunctions may be attributed to injury, neurological disorders, or musculoskeletal conditions, resulting in pain, instability, and potential falls. You should see a physical therapist to establish the cause and recommend the right treatment plan.

At Suarez Physical Therapy, we focus on restoring the patient’s ability to move around and be more independent by treating various gait issues. We are located in Las Vegas and offer individualized care to each patient, emphasizing their goals. We will be there with you, from the diagnosis to the specific treatments intended to help you alter your gait.

Overview Of Abnormal Gait

Walking is among the most natural human activities. However, when something disrupts the normal rhythm, it impacts one's ability to move and health. The term ‘gait’ describes how an individual moves or walks, including speed, rhythm, and coordination of movements. A normal gait requires muscle coordination and correct joint positioning to achieve a smooth and efficient walking pattern. However, when you experience a disruption of this pattern, this is called an “abnormal gait. ”

An abnormal gait can occur in mild forms, and in severe forms, you might need a wheelchair. How you move can be influenced by disorders resulting from an injury or a neurological or muscular problem. An impaired gait is a mobility problem with pain, discomfort, or a predisposition to fall. However, it depends on your particular type of gait disorder.

Gait dysfunction can also impact muscles, nerves, or joints. Early intervention in gait issues can help prevent the situation from worsening and further deteriorating mobility.

Types Of Gait Abnormalities

Gait abnormalities are classified based on their causes and characteristics, including:

• Antalgic gait. This gait arises when walking becomes painful. You might shorten the time spent on the affected leg to reduce discomfort. This can be due to injury, arthritis, or other pain-inducing conditions.

• Propulsive or Parkinsonian gait. Propulsive gait, often seen in Parkinson’s patients, causes you to lean forward while walking as though you are rushing to catch up with your center of gravity.

• Scissors gait. People with scissors gait tend to cross their legs in a scissor-like motion due to conditions affecting the brain or spinal cord, such as cerebral palsy.

• Vestibular unsteadiness. It stems from balance issues related to inner ear problems, making one feel unstable or dizzy while walking.

• Spastic gait (hemiplegic gait). A spastic gait, also called hemiplegic gait, is characterized by stiffness in the muscles, often resulting in a dragging leg. This type of gait frequently occurs in people who have had a stroke or suffer from neurological disorders.

• Steppage gait (neuropathic gait). A steppage gait occurs when you have difficulty lifting your foot, causing you to lift your leg higher than average in an exaggerated motion. Neuropathy or muscle weakness often causes this type of gait.

• Waddling gait (Myopathic gait). A waddling or myopathic gait causes a side-to-side motion as the body compensates for weakened hip muscles, making you resemble a penguin while walking.

• Crouching gait. Another abnormality is a crouching gait, characterized by bent knees and a stooped posture. This gait is commonly seen in individuals with muscular dystrophy.

• Ataxic gait. It involves uncoordinated, wide-based steps, which are often associated with neurological conditions like multiple sclerosis or alcohol intoxication.

• Shuffling gait. Shuffling gait shows small, dragging steps and is frequently linked with Parkinson’s disease.

• Lurching gait. Lurching gait presents with a noticeable hip or shoulder drop.

• Diplegic gait. This gait is often seen in cerebral palsy patients. It involves stiff legs that swing in a circular motion during walking.

How Common Are Gait Abnormalities?

Abnormalities in gait are not as rare as one would think. Many elderly patients have balance and strength problems, resulting in decreased mobility and more frequent gait disorders. Other factors include age, obesity, arthritis, stroke, and neurological diseases that make the chances higher.

According to prior studies, up to 35 percent of adults aged 70 and above may develop gait disorders. Young people can also experience these dysfunctions because of injuries and congenital or neurological disorders.

Symptoms and Causes of Gait Dysfunctions

Gait abnormalities can manifest in many ways, hence the need to identify their signs and causes. The first sign is that your normal gait is affected, which may indicate something is wrong.

Symptoms of Gait Abnormalities

Depending on the type of gait dysfunction, symptoms may be different. However, some are apparent. Some of the symptoms you may experience include:

• Unsteady or awkward waking pattern

• Difficulty maintaining balance

• Pain, stiffness, or leg weakness

• Deformities in the legs or feet

• Steps are smaller, more exaggerated, or jerky, indicating a loss of coordination or muscle control

In more severe cases, symptoms can progress to:

• Fatigue

• Difficulty walking long distances

• Inability to walk without assistance

For individuals with neurological conditions, cognitive symptoms such as confusion or memory loss can compound the physical difficulties associated with an abnormal gait.

Causes of Gait Abnormalities

The causes of gait abnormalities are as diverse as the symptoms themselves. These include:

• Injuries

Leg, hip, or spine injuries can result in a change of gait, either temporary or permanent. For example, a person could change their gait due to a fracture, muscle rupture, or ligament injury that could make them limp. Likewise, conditions affecting the joint, such as arthritis or bursitis, could cause pain every time you move and alter your gait.

• Neurological Disorders

Neurological problems are also among the leading causes of abnormal gaits. Parkinson’s disease, stroke, multiple sclerosis, and cerebral palsy are some of the diseases that affect the nervous system, thus impairing the communication between the brain and muscles. Such discoordination may lead to stiffness, muscle weakness, or incoordinate movements and balance, leading to gait disturbance.

In other circumstances, inner ear or vestibular disorders can lead to balance-related gait disturbances that may cause stumbling.

• Muscular Conditions

Neuromuscular diseases like muscular dystrophy or myopathy affect the muscles, making them lose strength and the body’s ability to posture and coordinate movements.

• Congenital Conditions

Congenital disorders at birth, such as clubfoot or developmental dysplasia of the hip, may also cause abnormal gait, affecting the structural alignment of the lower limbs.

Risk Factors for Gait Abnormalities

Several factors increase the likelihood of developing gait abnormalities. One factor is age. During aging, muscles become less powerful, flexibility decreases, and reaction time decreases. So, with age, you are likely to develop other diseases, such as osteoarthritis or osteoporosis, that could render you vulnerable to injuries that affect your gait. Also, some diseases like Parkinson’s disease or dementia are more frequent with age, and they also affect the gait.

Other risk factors include a history of injury or surgery to the lower body, which may result in chronic pain or limited mobility. If you have suffered a stroke, your risk of developing a spastic or hemiplegic gait increases.

Lifestyle factors such as inactivity, poor posture, and obesity can also disrupt normal gait patterns, as they put additional strain on the muscles and joints involved in walking.

Diagnosis and Tests

When it comes to diagnosing gait dysfunctions, precision is critical. Human gait is a complex mechanism that involves coordination between muscles, joints, nerves, and the brain. Therefore, an accurate diagnosis is crucial in pinpointing the underlying cause and determining the best course of treatment.

Your physical therapist should take a thorough, multi-step approach to assessing your gait and identifying potential dysfunctions. The physician can discover the root of your condition through a combination of tests and screenings.

1. Observation. Here, your physical therapist watches you walk and notes any movement irregularities. They will look for asymmetries, unusual foot placement, or changes in stride length. How you move can reveal a great deal about the potential cause of your abnormal gait. For example, a limp may indicate an antalgic gait, while a forward-leaning posture might suggest a propulsive gait common in Parkinson’s patients.

2. Gait speed measurements. These measurements assess how quickly you can walk over a distance. Speed is often an indicator of your overall mobility and can be a marker of how severe your gait dysfunction is. A decrease in walking speed may suggest underlying muscle weakness, joint problems, or neurological impairments.

3. Balance tests. Maintaining balance while standing or moving can reveal critical muscle control and coordination information. Gait abnormalities often arise from poor balance, especially in cases where the inner ear, vision, or proprioception (your body’s ability to sense movement and position) is affected.

4. Strength and range-of-motion measurements. These examine the strength and flexibility of the muscles and joints involved in walking. If you have limited range of motion in your hips, knees, or ankles, this could be the source of your gait dysfunction. Similarly, weakened muscles can result in an unsteady or uncoordinated gait.

5. Reflex and sensation screenings. The physician performs these screenings to check your nervous system's function. Abnormal reflex responses may indicate that a neurological issue, such as multiple sclerosis or a spinal cord injury, affects your walking ability. Additionally, if you have lost sensation in your feet or legs due to conditions like diabetic neuropathy, you may be unaware of how your body is moving, leading to a disrupted gait pattern.

6. Heart rate and blood pressure measurements. Cardiovascular issues such as low blood pressure or poor circulation can sometimes lead to dizziness or unsteadiness while walking. By monitoring your heart rate and blood pressure during movement, your physician can rule out these factors as contributors to your abnormal gait.

Management and Treatment

Gait abnormalities are not treated the same way as other disorders since treatment depends on the origin of the dysfunction. Physicians use different treatment techniques to correct gait abnormalities, improve balance, and stabilize muscles involved in walking.

Pre-Gait Training

Pre-gait training is usually the first stage in the management of gait disorders. This phase helps build up one's body to the gait rehabilitation level by enhancing strength, flexibility, and coordination.

Physicians focus on basic movements that contribute to walking patterns in this stage. These exercises may include mobilizing the hip, knee, and ankle joints or developing muscle tone in the abdominal wall to better support the spinal column.

Solving these basic problems guarantees that you are prepared to proceed to more complex gait training strategies.

Gait Training

Once pre-gait training has been completed, it is followed by gait training. This is where the rehab process addresses the specific abnormalities in your walking pattern. Gait training entails several activities and repeated movements that are intended to retrain how one moves.

At this stage, your physical therapist may use assistive devices, for example, parallel bars or harnesses, to ensure that you master how to walk without a risk of falling. You will be taken through a series of exercises that address your specific type of gait abnormality, such as foot drop, balance, or step length.

Gait training is all about practice. By executing these movements repetitively, the muscles and nervous system evolve to make walking more natural and smooth the next time.

Balance and Coordination Training

Besides gait training, balance and coordination training is essential in regaining your ability to walk independently. Most gait dysfunctions are caused by instability or poor synchronization, making it hard for an individual to walk in a coordinated manner.

To address this, we concentrate on exercises that help your body understand its position in space. Such exercises can include balancing on one leg, walking with the heels touching the ground first, or walking through obstacle courses that are meant to test your balance.

The goal is to increase your balance so you can walk easily and more confidently.

Neuromuscular Re-Education

Another critical part of your therapy may be neuromuscular reeducation. In this therapy, efforts are made to retrain the nerves and muscles to correct this improper coordination.

In many patients, especially neurological patients, the brain-body relationship is interfered with, leading to poor movement. Neuromuscular re-education involves activities that enhance this interaction. These activities involve coordination, timing, and muscle coordination, which are essential in normal walking.

Bracing or Splinting

The physical therapist may sometimes suggest lumbar bracing or splinting to address an abnormal gait pattern. These devices offer supplementary support to joints that are either weak or out of alignment, thus enabling you to move around without putting much strain on muscles or other joints.

Braces can be made in different sizes, so you can acquire the brace that suits your needs. Although braces and splints do not correct gait dysfunction, they may decrease pain and prevent additional injury while the patient undergoes therapy.

Like any other treatment, it may have complications. Some people may feel minor aches, such as muscle stiffness, fatigue, or mild discomfort, during the first weeks of rehabilitation or when learning to walk with an assistive device.

As a precaution, bracing or splinting should be done for an extended period; however, if not well-fitted, this may cause skin abrasions or joint contractures may result from joint immobilization. These side effects are usually minor and can be controlled by proper monitoring by your physical therapist. You must report feelings of pain during the treatment so that changes can be made to ensure that you are making progress safely and effectively.

Prevention

Genetic factors, neurological disorders, or injuries cause some gait conditions. However, others can be avoided or at least reduced if the problem is detected and treated at an early age. The prevention of gait abnormalities mainly involves the general health of an individual and the musculoskeletal system and the early assessment of any factors that might lead to such problems.

Physical Activity

Regular exercise is among the most successful strategies for preventing gait conditions. Exercising strengthens muscles directly responsible for supporting the joints, and one gains flexibility and balance.

Whether one walks, swims, or is strength trained, exercise may slow down the muscle and joint degeneration process, which are critical components of gait. More movement also helps the system be healthy, essential in avoiding falls that may lead to a gait problem.

Early Treatment Of Injuries

When you have a slight twist, break, or strain, seek medical attention and ensure adequate rest. Most gait abnormalities result from failure to treat injuries or poor treatment, which results in using other body parts to compensate for the affected areas. You must ensure that you receive early treatment for injuries to prevent developing chronic diseases that may affect your gait.

Maintain Healthy Weight

Keep your weight in check to alleviate the pressure on muscles and joints in the lower extremities. Obesity puts pressure on your hips, knees, and ankles, which in turn puts you at risk of developing joint disorders that alter your walking pattern.

It also means that when you take care of your weight with proper dieting and exercising, you reduce the stress on your joints and muscles to avoid developing an abnormal gait as you age.

Treatment Of Some Health Issues

Managing diabetes can avoid peripheral neuropathy, a condition that affects the nerves of your feet and legs and may result in gait problems. Likewise, treating diseases that can cause gait abnormalities, such as arthritis or osteoporosis, with medication, physical therapy, or other lifestyle changes can help avoid the development of such abnormalities.

Find a Physical Therapist Treating Gait Dysfunctions Near Me

Gait abnormalities can disrupt every aspect of your life, from basic functioning to the most critical elements of one’s life. Finding the right physical therapist will enable you to regain control, enhance mobility, and alleviate pain. At Suarez Physical Therapy, we assess and treat different gait abnormalities. If you reside in Las Vegas, have any challenges, or feel uncomfortable walking, please call us at 702-368-6778 to book your appointment.