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How to patch up that abnormal gait
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How to patch up that abnormal gait

Joint problems in the hip and knees affect the gait of many older people. Hence the importance of using assistive devices and getting regular health check-ups for the bones, ears and eyes

how to patch up that abnormal gait

Abnormal gait or difficulty walking is a common problem that the elderly face. Pain is the first sign of abnormal gait. But if that pain does not subside, it may indicate the presence of a more serious underlying condition. An optimally functioning neurological system is essential to walk properly.

Experts advise avoiding putting pressure on the painful areas as it may lead to limping and deformity.


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What causes abnormal gait?

Osteoarthritis of the knee is a common cause of gait abnormalities, says Dr Minesh Mehta, senior physician and critical care specialist at Shalby Hospital, Ahmedabad. “In osteoarthritis, there is loss of the space between the two bones where the joints and bones slide against each other, causing the pain,” he explains.

Dr Mehta recalls the case of an octogenarian woman whose osteoarthritis was so severe that she was almost bound to the wheelchair.  “Due to her multiple illnesses, surgery was not recommended. But her pain was so intense that she cried every night.”

In her case, the family opted for knee replacement surgery after a thorough discussion with the doctor. They decided to take the risk and got her knee replacement surgery done one after the other.

“It was a high-risk surgery and was successful. After the surgery, she was able to walk with the support of her walker. It was worth the risk,” said Dr Mehta.

Other causes of abnormal gait, as Dr Mehta lists, are:

  • Muscle weakness (due to low physical activity)
  • Obesity
  • Low sodium
  • Diabetes
  • A history of hemorrhage
  • Block in the vessels of the brain
  • Parkinson’s disease
  • Brain tumour
  • Spine-related problems
  • Compression of the nerves in the spine

 

Dr Haroon Hussain, consultant, internal medicine and diabetologist at KMC Hospital Mangaluru, says that having a low locomotor system (reduced mobility of musculoskeletal system) and impairment in the function of the cardiovascular system, joint and muscles, vestibular (responsible for the body’s balance, coordination and spatial orientation) and the sensory system could also lead to gait abnormality. “These could lead to falls and structural deformity which leads to difficulty in walking.”

Besides, stroke, conditions related to the peripheral nervous system (like autoimmune diseases) and musculoskeletal system, impairment of cognitive function or conditions like Alzheimer’s and dementia cause abnormal gait, doctors say.

“When an elderly person is injured either due to a fall or a fracture, they sometimes don’t regain the confidence to walk even after recovery. This itself can lead to issues related to mobility along with social isolation, anxiety and depression among the elderly,” adds Dr Hussain.

Sudden loss of walking ability

Older adults may suddenly be unable to walk due to falls that result in leg, hip or spinal fractures and hemorrhage. Other common causes are systemic problems or the intake of multiple drugs. Low sugar, low oxygen and severe dehydration may lead to sudden changes in the gait pattern, says Dr Mehta.

Preventing and treating walking difficulty

  • Plan ahead and improve bone and muscle strength in your late 30s, early 40s or even sooner.
  • Add balance training to your fitness routine – it keeps the muscles and joints active.
  • Seek advice from a healthcare provider about the risk of fractures and the body’s requirement of vitamins and minerals.
  • Drug interactions in the body can lead to postural hypotension (a drop in blood pressure with sudden postural changes). Make sure your prescription is reviewed regularly.
  • Watch out for symptoms like dizziness, vertigo, blurring vision and unsteadiness which can make the elderly more prone to falls.
  • Regular hearing and vision check-up is essential alongside wearing suitable vision glasses and hearing aids
  • Assistive devices at home, the workplace or in public places, such as grab bars, support bars, locomotive devices, ramps and non-skid floors can make the elderly’s life easier.
  • It is important to find the cause of abnormal gait. For osteoarthritis, the initial treatment can include physiotherapy and muscle strengthening.

 

Dr Mehta says, “It is important to look for underlying health conditions and deficiencies in the body like calcium, vitamin B-12 and vitamin D3. These deficiencies need to be corrected. If the problem persists, joint replacement surgery is recommended to correct the deformity.”

Takeaways

  • Gait abnormalities occur when a person is unable able to walk properly.
  • Abnormal gait may be caused due neurological disorders, osteoarthritis of the knees, diabetes, low sodium or other factors.
  • Parkinson’s gait, hemiplegic gait, ataxic gait, and scissor gait are some types of abnormal gait.
  • The key lies in the prevention and treatment of gait abnormalities.

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