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Walking/gait abnormalities
Definition:
Walking or gait abnormalities describes unusual and uncontrollable problems with walking.

Alternative Names:
Gait/walking abnormalities

Considerations:
The pattern of how a person walks is called the gait. Many different types of gait abnormalities are produced unconsciously. Most, but not all, are due to some physical malfunction.

Some gait abnormalities are so characteristic that they have been given descriptive names:
  • Propulsive gait (characterized by a stooped, rigid posture, with the head and neck bent forward)
  • Scissors gait (characterized by 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 (characterized by a stiff, foot-dragging walk caused by one-sided, long-term, muscle contraction)
  • Steppage gait (characterized by foot drop where the foot hangs with the toes pointing down, causing the toes to scrape the ground while walking)
  • Waddling gait (characterized by a distinctive duck-like walk that may appear in childhood or later in life)
Abnormal gait may be caused by disease in many different areas of the body. Typical groupings might consist of:
Common Causes:
ABNORMAL GAIT IN GENERAL CAUSES OF SPECIFIC GAITS
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.
  • Use of a cane or a walker is recommended for those with poor balance.
For a steppage gait:
  • Adequate rest is encouraged. Fatigue can often cause affected people to stub their toes 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.
Call your health care provider if:

If there is any sign of uncontrollable and unexplained gait abnormalities, call your health care provider.
What to expect at your health care provider's office:
The medical history will be obtained and a physical examination performed.

Medical history questions documenting the problems with walking in detail may include:
  • Time pattern
    • When did this problem with walking begin?
    • Did it occur suddenly or gradually?
    • Has it become worse over time?
  • Quality (type of gait disturbance)
    • Scissors gait (flexed hips and knees; legs cross each other)
    • Steppage gait (foot drop; toes scrape ground)Sspastic gait (stiff, foot-dragging walk)
    • Propulsive gait (stooped, rigid posture; head, neck bent forward)
  • Other symptoms
  • Medications
    • What medications are being taken?
  • Injury history
    • Have there been any recent or past leg injuries?
    • If there was a leg injury, what type? Was it a broken bone, dislocation, or burn?
    • Has the person had any head injuries, especially one that resulted in a coma?
    • Has the person had any spinal injuries or nerve injuries?
  • Illness history
  • Treatments
  • Self and family history
The physical examination will probably include neurological examination. Diagnostic tests will be determined by the results of the physical examination workup and observation of the gait abnormalities.

After seeing your health care provider:
You may want to add a diagnosis related to gait abnormality to your personal medical record.
Review Date: 7/27/2001
Reviewed By: Galit Kleiner-Fisman MD, FRCP(C), Department of Neurology, University of Toronto, Toronto, Ontario, Canada. Review provided by VeriMed Healthcare Network.
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