Abnormal Gait: Types, Diagnosis, and Recovery

Types of Abnormal Gaits

Abnormal gait is classified as one of five types based on a person's symptoms or appearance of gait:

• Spastic gait
• Scissors gait
• Steppage gait
• Waddling gait
• Propulsive gait

Besides these five types, a person with a limp is also considered to have an abnormal gait. Like other abnormalities, lameness can be temporary or permanent. A limp can also disappear without medical intervention.

Causes of Abnormal Gaits

Sometimes, a person may have difficulty walking because of an acute problem, such as a bruise, cut, or fracture. These may also cause them to limp or walk differently, but they aren't considered causes of abnormal gait.

However, several diseases can attack the nervous system and legs, causing abnormal gait. Some more common causes of abnormal gait include:

• Injury
• Trauma
• Inflammation
• Pain

Long-term difficulties are often the result of neurological muscle problems. Problems with gait, balance, and coordination are frequently due to particular conditions, including:

• Joint pain or conditions, such as arthritis
• Multiple sclerosis (MS)
• Meniere's disease
• Brain hemorrhage
• Brain tumor
• Parkinson's disease
• Chiari malformation (CM)
• Compression or infarction of the spinal cord
• Guillain-Barre syndrome
• Peripheral neuropathy
• Myopathy
• Drop
• Muscular dystrophy
• Obesity
• Chronic alcohol abuse
• Vitamin B12 deficiency
• Vertigo
• Migraine
• Deformities
• Certain medications, including antihypertensives

Other reasons encompass a restricted range of movement and fatigue. Muscle weakness can arise in a single leg, making the walk difficult. Numbness in the feet and legs can make it difficult to tell where the feet are moving or if they are touching the floor.

Symptoms of Abnormal Gait

• Shuffling Walk: Small steps or dragging feet while walking.
• Instability: Loss of balance or difficulty maintaining posture.
• Dizziness or Vertigo: Feeling lightheaded or unsteady while walking.
• Wide Stance: Walking with feet apart for better balance.
• Slow Walking: Reduced speed or cautious movement while walking.
• Stumbling or Falling: Frequent tripping or falling during movement.
• Limping: A noticeable limp due to pain or weakness in the legs or feet.
• Difficulty Turning: Struggling to make turns smoothly while walking.

Health Conditions That Can Cause Abnormal Gaits

Several health conditions can lead to an abnormal gait, including:

• Parkinson's disease or Parkinsonism.
• Multiple sclerosis.
• Stroke
• Arthritis
• Cerebral palsy
• Hemiplegia
• Spinal stenosis
• Herniated disk

When to Visit a Doctor?

Make an appointment with your doctor if you've recently fallen or if your unsteady gait makes you feel like you might fall. Take steps to stay safe and reduce the risk of future injury, along with any of the following signs:

• An injury fall or a head fall
• Cannot speak clearly
• Shortness of breath
• Dizziness
• Fell on one side of the face
• Loss of bladder or bowel control
• Occurs after a head injury
• Severe, stabbing headache
• Sudden confusion
• Sudden numbness in one or more parts of the body
• Sudden change in gait pattern

Diagnosis of Abnormal Gaits

• Your doctor will begin by taking a thorough medical history, including details about your current medications.
• It's crucial to disclose any history of falls, near falls, as well as alcohol or recreational drug use.
• Tests such as a nerve conduction study and electromyogram can assess muscle problems and peripheral neuropathy.
• Blood tests may also be ordered to identify potential causes of balance issues.
• Next, your doctor will evaluate your gait to observe how you walk.
• You may be asked to walk from head to toe, and other factors such as posture, stride length, and the need for assistance while walking will be considered.
• Your doctor can rate your gait using the Functional Ambulation Rating Scale, which ranges from zero to five. A score of five indicates independent walking without assistance from others.

Performance tests can be used to assess individual gait difficulties. Other possible tests to identify causes include:

• Hearing tests
• Inner ear tests
• Vision tests, including observation of eye movement

Then, a doctor will consider whether you have related symptoms that may require additional testing. These may include:

• Blood pressure checks in lying, sitting, and standing positions
• Blood tests to detect hemoglobin levels, thyroid function, electrolytes, blood glucose, and vitamin B-12 tests
• Cognitive function tests
• Depression detection
• Eye exams

Diagnosis and testing methods may vary because the cause can be an unsteady gait. An MRI or CT scan can test your brain and spinal cord. Your doctor will look for which part of the nervous system is contributing to your gait and balance problems.

Treatments of Abnormal Gaits

Treatment for abnormal gait varies depending on the underlying cause. Some common approaches include:

• Medications: Prescribed for conditions like arthritis, depression, hypothyroidism, Parkinson's disease, and vitamin B-12 deficiency.
• Physical Therapy: Focuses on improving strength, balance, and coordination.
• Assistive Devices: Use of canes, walkers, crutches, or leg braces to assist with walking.
• Surgery: Required for spine-related issues such as lumbar or cervical stenosis.
• Hearing Aids: Help if hearing loss is contributing to balance problems.
• Vision Correction: New glasses or updated prescriptions can improve stability.

For gait problems caused by injuries, treatment will improve once the injury is healed. Long-term cases may require rehabilitation to retrain proper walking techniques.

Prevention of Abnormal Gait

• Regular Exercise: Strengthen muscles and improve balance through activities like walking, swimming, or yoga.
• Healthy Weight Maintenance: Reduces stress on joints and helps prevent gait problems.
• Foot Care: Wear proper footwear and address any foot-related issues early.
• Control Chronic Conditions: Effectively manage conditions such as diabetes or arthritis to avoid gait problems.
• Safety in the Home: Eliminate tripping hazards and use assistive devices as needed to prevent falls.
• Regular Health Checkups: Visit your healthcare provider regularly to manage conditions that may impact walking.

Home Remedies for Abnormal Gaits

Since foot drop can increase the risk of tripping and falling, consider taking these precautions at home:

• Foot Exercises: Strengthen foot muscles with toe raises and ankle rotations.
• Hot and Cold Compresses: Use for muscle relaxation and to reduce inflammation.
• Epsom Salt Bath: Soak feet in warm water with Epsom salts to ease pain and improve circulation.
• Proper Footwear: Wear supportive, well-fitted shoes for better stability.
• Diet and Nutrition: Eat a balanced diet, rich in vitamins like B-12, for nerve and muscle health.
• Hydration: Drink plenty of water to keep muscles functioning well.
• Strengthening Core Muscles: Engage in core exercises to improve balance and stability.
• Balance Training: Practice standing on one leg to improve coordination.
• Avoid Overexertion: Rest to prevent strain and reduce abnormal gait.