Abnormal Gait : Symptoms, Causes and Treatments

Overview

The way a human being walk is called gait. Walking may look straightforward and uncomplicated, but several body parts, including eyes, ears, brain, muscles, and sensory nerves, rely on each other for a proper gait. When these body parts fail to function, it causes walking difficulties or gait disorders.

From arthritis to neurological conditions and sometimes an ill-fitting shoe can cause walking difficulties, falls, or injury. Addressing these causes with a medical practitioner may help correct the gait. Gait disorders can be temporary or long-term, based on the cause. 

The blog explains gait disorders, their types, symptoms, causes, treatment options, and various home remedies. 

What is abnormal gait?

As mentioned earlier, the word ‘gait’ means the pattern in which a person walks. Walking involves coordinating several body parts to move the body forward in a rhythm known as a stride. But when any of these body parts fail to function efficiently, it causes an abnormal gait. 

An abnormal gait is a symptom of an underlying health condition. It is caused due to several reasons, such as illness, genetic factors, injury, and defects in the legs and feet. Sometimes, the gait disorder may clear up on its own. Otherwise, it may be permanent. Physical therapy helps alleviate the symptoms and reduce the uncomfortable symptoms. Older adults are at a higher risk of developing this disorder. A gait disorder affects a patient’s quality of life and puts them at a higher risk of frequent falls and injuries.

What are the types of abnormal gait?

During a physical examination, the doctor observes how a patient walks, which may provide clues about the underlying health condition causing abnormal gait. Doctors have categorized the types into the following: 

1. Hemiplegic gait: It affects only one side of the body. The patient’s one arm stays at the side and does not move while walking. The patient also drags their leg in a semi-circle on the same side of the affected arm. This kind of gait is a result of a stroke. 
2. Diplegic gait: It affects both sides of the body. One of the signs is that the patient’s hip and knee may appear bent and the ankles turned in. The patient may move with a swinging effect. The diplegic gait develops due to cerebral palsy, stroke, and head trauma. 
3. Neuropathic gait: It is also known as the foot drop, as one foot flops down when the patient tries to lift their leg. Therefore, they must pull their knee high enough to prevent the toes from dragging on the ground as they walk. This type of gait is a symptom of multiple sclerosis (MS), amyotrophic lateral sclerosis (ALS), or peripheral neuropathy. 
4. Myopathic gait: It is commonly known as a waddling gait. A patient with a myopathic gait walks with a side-to-side movement, often due to weakness in the pelvic area. It is also a result of a hip issue present since birth. Myopathic gait can also be a symptom of muscular dystrophy, other muscle diseases, or spinal muscle weakness.
5. Ataxic gait: The patient may be unable to walk in a straight line or may walk side to side. Therefore, it is also called the staggering movement. The patient may have balance issues while standing but may not sway when walking. It is a symptom of alcohol intoxication and gets better as soon as the person is sober. But it can be due to the side effects of medication and, in severe cases, a brain injury. 
6. Parkinsonian gait: The sign of a parkinsonian gait is that the patient is stooped forward with their back and neck bent. Instead of a longer stride, the patient may take a smaller stride. It looks like they are in a stooping and rigid position and is also  known as a propulsive gait. 
7. Spastic gait: A person with spastic gait drags their feet while walking. Such patients appear to be very stiff when walking.
8. Scissors gait: People with scissors gait have legs bent inwards. These people, when walking, legs cross and may hit each other. The crisscross motion when walking looks like a scissor opening and closing.
9. Steppage gait: When the toes point towards the ground when walking is known as steppage gait. Usually, the toes get scraped against the ground when the person steps forward.

What are the symptoms of abnormal gait?

The common symptoms of abnormal gait are as follows:

• Difficulty walking
• Balance issues
• Instability

People with gait disorder also experience the following:

• Dizziness
• Light-headedness
• Vertigo
• Motion sickness
• Double vision

Some patients may experience other symptoms due to their underlying health conditions.

What are the causes of abnormal gait?

The possible causes of temporary gait or balance difficulties include injury, trauma, inflammation, and pain. Issues with the gait, balance, and coordination are a result of specific conditions, such as the following: 

1. Joint disorders, such as arthritis
2. Multiple sclerosis
3. Meniere’s disease 
4. Brain haemorrhage and tumour
5. Neurological disorders, including Parkinson’s disease and Chiari malfunction
6. Spinal cord compression or infraction
7. Autoimmune disorders, such as Guillain-Barre syndrome
8. Peripheral neuropathy
9. Myopathy
10. Cerebral palsy
11. Gout
12. Muscular dystrophy
13. Obesity 
14. Chronic alcohol misuse
15. Vitamin B12 deficiency
16. Stroke 
17. Vertigo
18. Migraine
19. Deformities
20. Side effects of medications, such as antihypertensive drugs
21. Chronic pain due to medical conditions, such as arthritis 
22. Past injuries to the legs or feet
23. Pain and weakness in the feet
24. Inner ear issue
25. Heart disease 
26. Respiratory disorder
27. Obesity
28. Infections in the soft tissues of the legs and inner ears
29. Tendonitis 
30. Conversion disorder or other psychological disorder 
31. Shin splints 

What are the treatment options for abnormal gait?

Based on the cause of the abnormal gait, the doctor can decide on a treatment plan. Treating the disease automatically corrects the gait abnormality if the reason is an underlying health condition. Sometimes, certain medications also cause abnormal gait. In such cases, the doctor may discontinue or change the medicine. 

Injury-related gait problems, such as fractures, can be corrected with assistive devices, including casts, crutches, canes, and walkers. The patient may also need physical therapy and exercises to improve overall strength, minimize the effects, and gain as much mobility as possible. Although treatments may not completely correct the abnormal gait in some cases, they can decrease the severity of the symptoms. Sometimes, certain conditions may require surgery to correct abnormal gait. 

How is abnormal gait diagnosed?

The doctor assesses medical history and symptoms. The healthcare provider may also conduct a physical and neurological examination to diagnose the condition. They also observe how the patient walks. 

If the patient recently experienced an injury or the doctor suspects an underlying health condition, the doctors prescribe imaging scans such as X-rays, MRIs, and CT scans. These tests check the extent of the injury and neurological defects in the different parts of the brain and the spinal cord. The doctor may also prescribe other tests to assess individual gait difficulties and identify potential causes. These tests include hearing tests, inner ear tests, and vision tests.

Nerve conduction study and electromyogram evaluate muscle problems and peripheral neuropathy. The doctor may also get a blood test as well. 

There can be multiple causes of gait disorder and sometimes the causes may overlap. To diagnose this disorder, the doctor will observe your gait first. Next,

• Your spine and neck may be checked for deformities 
• Your muscle tone, muscle strength and coordination will be assessed
• Assessment of the risk of falling will be performed 
• Your legs will be checked to see if they are of same length (some patients with lower back pain or artificial hips may have legs of different lengths)
• You will be assessed for arthritis or neurologic disorders such as Parkinson’s disease epending on the type of gait disorder, 
• If you are older, blood pressure (both lying & standing) and your vision may be checked to rule out orthostatic hypotension (low blood pressure upon standing) or vision problems as the cause

Conclusion

Outcome depends on the cause of the gait disorder. With treatments and home remedies, the symptoms can be controlled from worsening and give the patient a certain amount of independence. However, it is crucial to ensure that older adults with gait issues must be precautions while walking as they could injure themselves from a fall. 

Frequently Asked Questions (FAQs):

What are the various specialists that a patient should visit for a gait disorder?

A patient can seek medical help from specialists, such as neurologists, orthopaedic surgeons, and podiatrists.

Who is at a higher risk of developing the gait disorder?

The chance of developing the disorder increase as a person ages. Older individuals experience several conditions that may lead to abnormal gait, muscle weakness, delayed reaction, and lack of coordination.