St. Luke's Hospital
Main Number: 314-434-1500 Emergency Dept: 314-205-6990 Patient Billing: 888-924-9200
Find a Physician Payment Options Locations & Directions
Follow us on: facebook twitter Mobile Email Page Email Page Print Page Print Page Increase Font Size Decrease Font Size Font Size
America's 50 Best Hospitals
Meet the Doctor
Spirit of Women
Community Health Needs Assessment
Home > Health Information

Multimedia Encyclopedia

    Print-Friendly
    Bookmarks

    Walking abnormalities

    Gait abnormalities

    Walking abnormalities are unusual and uncontrollable walking patterns. Theyare usually due to diseases or injuries to the legs, feet, brain, spinal cord, or inner ear.

    Considerations

    The pattern of how a person walks is called the gait. Different types of walking problems occur without a person's control. Most, but not all, are due toa physical condition.

    Some walking abnormalities have been given names:

    • Propulsive gait -- a stooped, stiff posture with the head and neck bent forward
    • Scissors gait -- legs flexed slightly at the hips and knees like crouching, with the knees and thighs hitting or crossing in a scissors-like movement
    • Spastic gait -- a stiff, foot-dragging walk caused by a long muscle contraction on one side
    • Steppage gait -- foot drop where the foot hangs with the toes pointing down, causing the toes to scrape the ground while walking, requiring someone to lift the leg higher than normal when walking
    • Waddling gait -- a duck-like walk that may appear in childhood or later in life

    Causes

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

    General causes of abnormal gait may include:

    • Arthritis of the leg or foot joints
    • Conversion disorder (a psychological disorder)
    • Foot problems (such as a callus, corn, ingrown toenail, wart, pain, skin sore, swelling, or spasms)
    • Fracture
    • Injections into muscles that causes soreness in the leg or buttocks
    • Infection
    • Injury
    • Legs that are different lengths
    • Myositis
    • Shin splints
    • Shoe problems
    • Tendonitis
    • Torsion of the testis

    This list does not include all causes of abnormal gait.

    CAUSES OF SPECIFIC GAITS

    • Propulsive gait:
      • Carbon monoxide poisoning
      • Manganese poisoning
      • Parkinson's disease
      • Use of certain drugs including phenothiazines, haloperidol, thiothixene, loxapine, and metoclopramide (usually drug effects are temporary)
    • Spastic (scissors) gait:
      • Brain abscess
      • Brain or head trauma
      • Brain tumor
      • Cerebrovascular accident (stroke)
      • Cerebral palsy
      • 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
    • Steppage gait:
      • Guillain-Barre syndrome
      • Herniated lumbar disk
      • Multiple sclerosis
      • Muscle weakness of the tibia
      • Peroneal neuropathy
      • Poliomyelitis
      • Spinal cord injury
    • Waddling gait:
      • Congenital hip dysplasia
      • Muscular dystrophy
      • Muscle disease (myopathy)
      • Spinal muscle atrophy
    • Ataxic or broad-based gait
      • Acute cerebellar ataxia
      • Alcohol intoxication
      • Brain injury
      • Damage to nerve cells in the cerebellum of the brain (cerebellar degeneration)
      • Medications (phenytoin and other seizure medications)
      • Polyneuropathy (damage to many nerves, as occurs with diabetes)
      • Stroke

    Home Care

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

    Physical therapy almost always helps with short-term or long-term gait disorders. Therapy will reduce the risk of falls and other injuries.

    For an abnormal gait that occurs with conversion disorder, counseling and support from family members are strongly recommended.

    For a propulsive gait:

    • Encourage the person to be as independent as possible.
    • Allow plenty of time for daily activities, especially walking. People with this problem are likely to fall because they have poor balance and are always trying to catch up.
    • Provide walking assistance for safety reasons, especially on uneven ground.
    • See a physical therapist for exercise therapy and walking retraining.

    For a scissors gait:

    • People with a scissors gait often lose skin sensation. Skin care should be used to avoid skin sores.
    • Leg braces and in-shoe splints can help keep the foot in the right position for standing and walking. A physical therapist can supply these and provide exercise therapy, if needed.
    • Medications (muscle relaxers, anti-spasticity medications) can reduce the muscle overactivity.

    For a spastic gait:

    • Exercises are encouraged.
    • Leg braces and in-shoe splints can help keep the foot in the right position for standing and walking. A physical therapist can supply these and provide exercise therapy, if needed.
    • A cane or a walker is recommended for those with poor balance.
    • Medications (muscle relaxers, anti-spasticity medications) can reduce the muscle overactivity.

    For a steppage gait:

    • Get enough rest. Fatigue can often cause a person to stub a toe and fall.
    • Leg braces and in-shoe splints can help keep the foot in the right position for standing and walking. A physical therapist can supply these and provide exercise therapy, if needed.

    For a waddling gait, follow the treatment your health care provider prescribed.

    When to Contact a Medical Professional

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

    What to Expect at Your Office Visit

    The health care provider will take a medical history and perform a physical examination.

    Medical history questions 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 drops, toes scrape ground)
      • Spastic gait (stiff, foot-dragging walk)
      • Propulsive gait (stooped, rigid posture, with head and neck bent forward)
    • Other symptoms
      • Is there pain?
      • If there is pain, is it in the muscles, joints, spine, or other location?
      • Is there a fever?
      • Is there pain in the testicles?
      • Does there appear to be muscle wasting (atrophy)?
      • Is there any paralysis?
      • Are there any muscle spasms?
      • Are there joint deformities?
      • Has there been a recent infection?
    • 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 led to a coma?
      • Has the person had any spinal injuries or nerve injuries?
    • Illness history
      • Are there any known blood vessel problems?
      • Are there any known illnesses such as polio, meningitis, myositis, tumors, or stroke?
      • Have there been any recent infections, including abscesses?
      • Does the person have hemophilia?
      • Has the person been exposed to carbon monoxide?
    • Treatments
      • Have there been any recent vaccinations?
      • Has there been a recent surgery?
      • Has there been any chemotherapy or radiation therapy?
    • Self and family history
      • Are there any known birth defects, such as spina bifida, myelomeningocele, or hip dysplasia?
      • Is there a history of cerebral palsy or muscular dystrophy?
      • Has anyone in the family had multiple sclerosis?
      • Has the affected person had any growth problems?
      • Are the legs different lengths?
      • Is there a known problem with scoliosis?

    The physical examination will include muscle, bone, and nervous system examination. The health care provider will decide which tests to do based on the results of the physical examination.

    References

    McGee S. Stance and gait. In: McGee S. Evidence-Based Physical Diagnosis. 3rd ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 6.

    Thompson PD Nutt JG. Gait disorders. In: Daroff RB, Fenichel GM, Jankovic J, Mazziotta JC. Bradley’s Neurology in Clinical Practice. 6th ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 22.

    BACK TO TOP

          A Closer Look

            Self Care

              Tests for Walking abnormalities

                Review Date: 2/27/2013

                Reviewed By: Luc Jasmin, MD, PhD, Department of Neurosurgery, Cedars Sinai Medical Center, Los Angeles and Department of Anatomy, University of California, San Francisco, CA. Review provided by VeriMed Healthcare Network. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, Bethanne Black, Stephanie Slon, and Nissi Wang.

                The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
                adam.com

                A.D.A.M. content is best viewed in IE9 or above, Fire Fox and chrome browser.


                Back  |  Top
                About Us
                Contact Us
                History
                Mission
                Locations & Directions
                Quality Reports
                Annual Reports
                Honors & Awards
                Community Health Needs
                Assessment

                Newsroom
                Services
                Brain & Spine
                Cancer
                Heart
                Maternity
                Orthopedics
                Pulmonary
                Sleep Medicine
                Urgent Care
                Women's Services
                All Services
                Patients & Visitors
                Locations & Directions
                Find a Physician
                Tour St. Luke's
                Patient & Visitor Information
                Contact Us
                Payment Options
                Financial Assistance
                Send a Card
                Mammogram Appointments
                Health Tools
                My Personal Health
                mystlukes
                Spirit of Women
                Health Information & Tools
                Clinical Trials
                Health Risk Assessments
                Employer Programs -
                Passport to Wellness

                Classes & Events
                Classes & Events
                Spirit of Women
                Donate & Volunteer
                Giving Opportunities
                Volunteer
                Physicians & Employees
                For Physicians
                Remote Access
                Medical Residency Information
                Pharmacy Residency Information
                Physician CPOE Training
                Careers
                Careers
                St. Luke's Hospital - 232 South Woods Mill Road - Chesterfield, MO 63017 Main Number: 314-434-1500 Emergency Dept: 314-205-6990 Patient Billing: 888-924-9200
                Copyright © St. Luke's Hospital Website Terms and Conditions  |  Privacy Policy  |  Patient Notice of Privacy Policies PDF Sitemap St. Luke's Mobile