Gait disorders refer to the abnormal way of walking, which may be due to skeletal, nervous, muscular or emotional changes in the body. The injuries, underlying conditions or problems with legs and feet are the reason for abnormal gait.
The ability to walk, which we take for granted, involves a complex set of signals, both sensory and motor. This includes strength, coordination and sensations. A number of muscles contract and expand to make the movement of walking possible. Further, the sensations of sight, hearing, balance, position and movement are all working together when a person takes steps ahead with each foot alternating.
Types of Gait disorders:
Gait problems due to an underlying neurological disease are of eight types:
- Hemiplegic gait
- Spastic diplegic
Abnormal gait, in general, is classified into five basic types, based on the manner of walking.
- Propulsive gait: The person’s movement is characterized by a stooping, rigid posture and bending of head and neck. As the person walks, the steps tend to become faster and shorter. This type of gait is typical of Parkinson’s disease.
- Scissors gait: As the name says, the knees and thighs bend inwards, giving them a scissors-like pattern when walking. The legs, hips and pelvis are flexed resulting in the person being in a crouching position. The steps taken are small and slow.
- Spastic gait: In patients with cerebral palsy or multiple sclerosis, when one leg is affected, it tends to be a long term muscle contraction. This makes the stiff leg drag in a semicircular motion while walking.
- Steppage gait: In conditions like peroneal muscle atrophy or nerve injury, the person walks by lifting each leg very high and drops the foot floppily. While walking the toes point downwards and scrape the ground.
- Waddling gait: While walking, the person moves the trunk excessively that appears like a duck-like walk. Congenital hip dislocation or muscular dystrophy produce this type of walk.
Apart from the types of gaits mentioned above, gait changes in overweight people. Abnormalities in gait of obese persons can occur due to the increased pressure of weight on tendons and muscles of the foot. Plantar fasciitis and flat-feet are common in people with obesity. Osteoarthritis in such people escalalte the gait abnormalities.
Diagnosis of Gait disorder:
The doctor first observes the gait of the patient. Based on the manner of walking, the doctor further looks into the following things.
- Difference in the length of legs
- Muscle strength, muscle tone and coordination of muscles
- Blood pressure
- Any deformities in the neck and spine
- Assessment of risk of falling
- Blood tests for arthritis
- Neurological tests for Parkinson’s disease and other such conditions
Gait disorders due to underlying diseases need to be treated. Rehabilitation of the persons with gait disorders involves assistive devices like canes and walkers. Physical therapy and exercises to strengthen the muscles can help in improving balance and flexibility in some patients.
Some people habitually walk in a wrong way so that weight of their body does not get distributed evenly. This may cause pains in specific muscles or abnormal shaping of the bone or muscle concerned. Modified shoes, leg braces, in-shoe splints or shoe-lifts usually help such people correct their gait. These corrections also improve the pain in specific muscles.