Walking abnormalities

Definition

Walking abnormalities are unusual and uncontrollable walk patterns, usuallycaused by diseases or injuries to the legs, feet, brain, spine, or inner ear.

Alternative Names

Gait abnormalities

Considerations

The pattern of how a person walks is called their gait. Many different types ofwalking abnormalities are produced unconsciously. Most, but not all, are due to some physical condition.

Somewalking abnormalities are so characteristic that they have been given descriptive names:

• Propulsive gait -- a stooped, rigid posture, with the head and neck bent forward
• Scissors gait -- legs flexed slightly at the hips and knees, giving the appearance of crouching, with the knees and thighs hitting or crossing in a scissors-like movement
• Spastic gait -- a stiff, foot-dragging walk caused by one-sided, long-term, muscle contraction
• Steppage gait -- foot drop where the foot hangs with the toes pointing down, causing the toes to scrape the ground while walking
• Waddling gait -- a distinctive duck-like walk that may appear in childhood or later in life

Abnormal gait may be caused by diseases in many different areas of the body. For example:

• Vestibular disorders (the inner ear is responsible for maintaining balance, and damage results in vertigo)
• Central nervous system disorders of the brain that cause muscular problems resulting in gait disturbance such as multiple sclerosis and cerebral palsy)
• Spinal cord abnormalities (disease, trauma, degeneration)
• Peripheral nerve diseases (nerves from the spinal cord to the muscles may be damaged by disease or trauma and result in gait abnormalities)
• Degenerative muscle diseases (muscular dystrophy, myotonic dystrophy, myositis)
• Neurodegenerative illnesses (Parkinson's disease)
• Skeletal abnormalities and disease
• Arthritis
• Foot conditions (plantar warts, bunions, ingrown toenails, pressure ulcers)
• Toxic reactions (alcohol, drugs, allergens)

Causes

ABNORMAL GAIT IN GENERAL

• Trauma
• Foot problems (such as a callus, corn, ingrown toenail, wart, pain, skin ulcer, swelling, spasms)
• Chondromalacia patellae
• Fracture
• Hemophilia
• Immunization (soreness in the leg or buttocks)
• Legs that are different lengths
• Myositis
• Tight or uncomfortable shoes
• Shin splints
• Infection
• Tendonitis
• Torsion of the testis
• Conversion disorder (a psychological disorder)

CAUSES OF SPECIFIC GAITS

• Propulsive gait:
  • Carbon monoxide poisoning
  • Manganese poisoning
  • Parkinson's disease
  • Drugs including phenothiazines, haloperidol, thiothixene, loxapine, metoclopramide, and metyrosine (usually drug effects are temporary)
• Scissors gait:
  • Cerebrovascular accident (stroke)
  • Cervical spondylosis with myelopathy (a problem with the vertebrae in the neck)
  • Liver failure
  • Multiple sclerosis
  • Pernicious anemia
  • Spinal cord trauma
  • Spinal cord tumor
  • Syphilitic meningomyelitis
  • Syringomyelia
  • Cerebral palsy
• Spastic gait:
  • Brain abscess
  • Brain tumor
  • Cerebrovascular accident (stroke)
  • Head trauma
  • Multiple sclerosis
• Steppage gait:
  • Guillain-Barre syndrome
  • Herniated lumbar disk
  • Multiple sclerosis
  • Peroneal muscle atrophy
  • Peroneal nerve trauma
  • Poliomyelitis
  • Polyneuropathy
  • Spinal cord trauma
• Waddling gait:
  • Congenital hip dysplasia
  • Muscular dystrophy
  • Spinal muscle atrophy

Home Care

Treatment of the cause often improves the gait. For example, gait abnormalities from trauma to part of the leg will improve as the leg heals.

For an abnormal gait that occurs with conversion disorder, psychiatric counseling as well as comfort and love from family members is strongly recommended.

For a propulsive gait:

• Encourage the person to be as self-reliant and independent as possible.
• Allow plenty of time for daily activities, especially walking. People with this problem are susceptible to falls because of poor balance and an unconscious effort to always catch up.
• Provide walking assistance for safety reasons, especially on uneven ground.
• Consult a physical therapist about exercise therapy and walking retraining.

For a scissors gait:

• Loss of skin sensation is often associated with scissors gait, so skin care should be provided in order to avoid skin breakdown and ulcers.
• Leg braces and in-shoe splints can help maintain proper foot alignment for standing and walking. A physical therapist can supply these and provide exercise therapy, if appropriate.

For a spastic gait:

• Both active and passive exercises are encouraged.
• Leg braces and in-shoe splints can help maintain proper foot alignment for standing and walking. A physical therapist can supply these and provide exercise therapy, if appropriate.
• A cane or a walker is recommended for those with poor balance.

For a steppage gait:

• Adequate rest is encouraged. Fatigue can often cause an affected person to stub his toe and fall.
• Leg braces and in-shoe splints can help maintain proper foot alignment for standing and walking. A physical therapist can supply these and provide exercise therapy, if appropriate.

For a waddling gait, follow the prescribed therapy.

When to Contact a Medical Professional

If there is any sign of uncontrollable and unexplained gait abnormalities, call your health care provider.