GAIT/BALANCE CHANGES

GAIT

A gait disturbance is a deviation from the normal pattern of movement in walking.  With the guidance   of a Movement Disorder Specialist, physical therapists and occupational therapists can teach methods for compensating for gait disturbances.  Remaining as physically active as possible helps to maintain muscle strength and independence.   People with gait disturbances are often uncomfortable in public, afraid that they may fall and worried that others will not understand that their mobility problems are out of their control.  A positive outlook and a good sense of humor are good tools to have.

FOOT/FEET DRAGGING

Foot or feet dragging occurs when body’s sense of orientation and placement becomes distorted as sensory signals from the muscles to the brain also encounter disruption. Foot/feet dragging increases the risk of injury because it increases the likelihood of stumbling and falling. To help prevent stumbling and falling concentrate on lifting each foot completely from the surface with every step.

FREEZING

Gait freezing occurs when walking or attempting to walk and the person cannot move.   It feels like your feet are anchored or rooted to the ground.   It usually occurs when there is a change in the walking surface, such as going from a carpeted room to a tiled floor, approaching stairs or getting on or off an elevator.  Anxiety about walking can increase the frequency of the freezing episodes. The duration of a freeze varies from a few seconds to as long as several minutes.   To cope with freezing episodes see the surface changes as obstacles that have to be stepped over.

START AND STOP HESITATIONS

Start and stop hesitations occur at the beginning or end of walking.  In start hesitation, the person is in position to walk but cannot initiate movement. In stop hesitation, the person is walking and suddenly stops.   Focusing on your movements will improve start/stop hesitations.

To cope with freezing and start/stop hesitations:

  • Rock or sway your hips from side to side/left to right  a couple of times.  This allows you to shift the anchored/rooted feeling.  Take a step forward as you are swaying your hips.  You will find swaying yours hips shifts your weight to one side which makes stepping forward easier.  As you sway to left, your right foot has less weight bearing down on it so you would step forward with the right foot.  (Sway to the left step with the right).

or

  • Count out loud or to yourself as you take each step.

It’s important not to over use this technique as the brain may become reliant, always try to move off naturally first.

BALANCE

A balance disturbance causes you to feel unsteady when you are sitting, standing, reaching, bending or walking.   Balance occurs as the result of several body systems working together:  the visual system (eyes), the vestibular system (ears) and proprioception (the body’s sense of where it is in space).  When your balance is impaired, you have difficulty standing upright.   You may stagger, fall or not be able to stand.

Balance disturbances may be accompanied by:

  • dizziness
  • vertigo
  • lightheadedness
  • feeling woozy
  • problems reading
  • difficulty seeing
  • disorientation
  • nausea
  • faintness
  • fatigue
  • anxiety
  • poor concentration

 

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