Thứ Hai, 13 tháng 1, 2014

Unsteady Gait

Unsteady Gait The term “Gait” means walking pattern and unsteady gait is the condition of walking abnormally. Abnormal gait results from number of causes like injury on the brain, spinal cord, injury caused to the legs and even trauma to the inner ear. Certain medical conditions like Parkinson’s disease, Guillain Barre Syndrome, and multiple sclerosis can cause unsteady gait.


Abnormal walking pattern is the result of uncontrolled muscular deformation on the legs and specific problems in brain and central nervous system. This is largely seen in old age people who may have difficulty in walking due to age factor and underlying medical issues. Old people will not have stability and balance in walking resulting in abnormal gait problem. For instance people with rheumatoid arthritis, cerebral palsy and muscular dystrophy will have difficulty in normal walking. Most of the gait problems can be resolved if the underlying cause is identified and treated.


Types :


Gait is described as the style of walking or how a person walks. Many times, we may not be able to control the walking pattern due to underlying physical or medical issues.


There are 5 types of unsteady gait based on the style of walking.


Propulsive gait is one which the person walks with stiff posture bending his head forward. Scissors gait will be like crouching with legs flexed at the hips and the knees and thighs will be hitting each other in the shape of scissors.


Spastic gait is the term that describes the walking style with stiff and dragging walk resulting from contraction of long muscle on one side.


Steppage gait is the style in which the foot drops and hangs leaving the toes pointing down. In this position the toes will scrape the ground when the person walks and the person have to make movement for lifting the leg in high position while walking.


Waddling gait resembles walking like a duck and this condition is seen in childhood.


Causes :


Unsteady gait is caused by many diseases in various parts of the body. Arthritis is the first cause affecting the joints of the foot making one to walk with difficulty and abnormal position. A person having foot problems like ingrown toenail, skin sore, callus and swelling on his foot will have abnormal walking pattern. Any trauma or injury with fracture to the legs can cause problem.


Some people will have difference in sizes of legs causing difficulty in normal walking. Tendonitis, infections on the foot, taking prolonged injections on the legs and buttocks, wearing improper shoes and shin splints can cause unsteady gait.


Propulsive gait is caused by poisoning of chemicals like carbon monoxide or manganese. It can occur as a side effect of Parkinson’s disease and intake of medications like phenolthiazine, loxapine, thiothixene.


Spastic gait and scissors gait is caused due to abscess in the brain, head trauma, tumor in the brain, stroke, cerebral palsy, multiple sclerosis, liver failure, trauma or injury on the spine and tumor in the spinal cord.


Steppage gait is caused due to muscle weakness, multiple sclerosis, lumbar disc problem, spinal cord injury, poliomyelitis and Guillain Barre Syndrome.


Wadding gait is the result of congenital hip dysplasia, myopathy or muscular weakness, muscular dystrophy and spinal cord problems.


Ataxic gait is caused by alcohol toxicity, acute cerebral problem, and brain injury, degeneration of nerve cells in the cerebellum, poly-neuropathy and intake of medicines like phenytoin.


Treatment :


Treating the cause of the problem is important for walking in normal pattern. In case if the person is suffering from conversion disorder, he should be given counseling along with family support to come out of the trauma. In case of physical injury or fracture taking complete rest is the best remedy for healing.


Propulsive Gait :


The person should be motivated to walk independently. It is necessary to practice exercises and learn the normal walking pattern. He will not have adequate balance hence is likely to fall on the ground while walking. For this reason people with propulsive gait should be allowed to walk only on even grounds and avoid uneven or rugged terrain. Through regular physiotherapy and training for walking, the conditions can be improved.


Scissors Gait :


This type of people will not have skin sensation and is prone to get skin sores. Leg braces and splinters can be used for walking in right position. Consulting a physical therapist is good for doing exercise therapy and getting trained for normal walking. In case of muscular problems you can take muscle relaxing drugs with consultation of doctor.


Spastic Gait :


Wearing shoe splinters and leg braces is highly useful for walking and standing alone. You can also use walker for overcoming the deficient of poor balance.


Steppage Gait :


Consult a physiotherapist for learning exercises and getting trained for normal walking style.


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