Causes of Pathological 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

Care to be given:

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.