Gait disorders - Causes, symptoms and treatment. MF.

I'm sure you always pay attention to a beautiful figure, a beautiful gait. Have you ever wondered what exactly provides our beautiful walk?

Central nervous system: the cerebral cortex, extrapyramidal and pyramidal systems, the brain stem, spinal cord, peripheral nerves, cerebellum, eyes, vestibular apparatus of the inner ear and of course the structures that all this directs - skeleton, bones, joints, muscles. Healthy listed structures, proper posture, smoothness and symmetry of movements ensure a normal gait.

The gait is formed from childhood. Congenital dislocations of the hip joints or the joint can lead, subsequently, to a shortening of the limb and a violation of the gait. Hereditary, degenerative, infectious diseases of the nervous system, manifested by muscle pathology, violation of tone( hypertonus, hypotension, dystonia), paresis, hyperkinesia also lead to disruption of the gait - infantile cerebral palsy, myopathy, myotonia, Friedreich disease, Strympel disease, Huntington's chorea, poliomyelitis.

Gait irregularities in myopathies

Properly selected shoes will influence the formation of the right gait. When the shoe is tight, the child will pinch his fingers, the formation of the arch of the foot is disturbed, joints can be deformed, as a result - joint arthrosis and gait disturbance. Flat feet, clubfoot violate the gait. Incorrect long sitting at the table will lead to curvature of the spine( scoliosis) and gait disturbance.

With proper walking, the trunk should slightly deflect backwards. The back should be kept exactly, the thorax cage straightened, the buttocks tightened. At each step, the feet should be placed on one line, while the socks should be turned outward. Keep your head slightly elevated. Look straight ahead or slightly up.

The defeat of the peripheral nerves - peroneal and tibial - leads to a disruption in the gait."Stepping" - when walking stop "slaps", because it is impossible to rear flexion( flexion) and stop hanging. When walking, a patient with a lesion of the peroneal nerve tries to lift the leg higher( so as not to pinch the floor with his fingers), the foot hangs down, when the foot is lowered with the support on the heel - the foot slaps to the floor. Another such gait is called "cock".The peroneal nerve is affected with compression - ischemic, traumatic, toxic neuropathies. Compression - this means that you have transmitted the nerve and / or blood vessels and has developed ischemia - circulatory failure. This is possible, for example, with a long sitting: "squatting" - repair, garden;in small-sized buses for long trips. Sports activities, very strong sleep in a clumsy pose, tight bandages, gypsum longes can cause blood circulation disorders in the nerves.

Hanging stop with affection of the peroneal nerve

The defeat of the tibial nerve makes it impossible to plant solely the flexion of the foot and toes and the turn of the foot to the inside. At the same time the patient can not stand on the heel, the arch of the foot deepens, the "horse" foot is formed.

"Horse" foot with affection of the tibial nerve

Ataxic gait - the patient walks with widely spaced legs, deviating to the sides( more often to the side of the affected hemisphere), as if balancing on an unstable deck, the movements of the hands and feet are not coordinated at the same time. Torso rotations are difficult. This is a "drunken walk".The appearance of an atactic gait may indicate a violation of the vestibular apparatus, a violation of blood circulation in the vertebro-basillar basin of the brain, and problems in the cerebellum. Vascular diseases, intoxications, brain tumors can be manifested by atactic gait and even frequent falls.

Antalgic gait - with radicular pain syndromes of osteochondrosis the patient walks, bending the spine( scoliosis occurs), reducing the load on the diseased root and thus the severity of the pain. With pains in the joints, the patient spares them, adapting the gait to reduce the pain syndrome - there is lameness, and with coxarthrosis, a specific "duck" gait - the patient is shifted from foot to foot like a duck.

With the defeat of extrapyramidal systems, Parkinsonism develops akinetic-rigid syndrome - movements are constrained, muscle tonus is elevated, movement friendly is broken, the patient is walking, bent over, bending his head forward, bending his arms in the elbow joints, small steps, slowly "shuffling" oversex. It is difficult for the patient to start moving, "disperse" and stop. When stopped, he continues for a while unsteady movement forward or sideways.

Gait of the patient Parkinsonism

When chorea develops hyperkinetic-hypotonic syndrome with violent movements in the muscles of the trunk and extremities and periods of muscle weakness( hypotension).The patient is walking, as it were "dancing" gait( Horea Huntington, the dance of St. Witt).

In the defeat of the pyramidal system with various diseases of the nervous system, paresis and paralysis of the extremities occur. So, after a stroke with hemiparesis, a characteristic posture of Wernicke-Mana is formed: the paralyzed hand is brought to the trunk, bent at the elbow joint and the arm-wrist, the fingers are bent, the paralyzed leg is maximally unbent in the hip, knee, ankle joints. When walking, it seems like an "elongated" leg. The patient, so as not to touch the floor with his foot, describes a semicircle - such a gait is called "circumulatory".In more mild cases, the patient limps, the muscular tone is increased in the affected limb and therefore the flexion in the joints is less when walking.

Gait with central hemiparesis

For some diseases of the nervous system, lower paraparesis of may develop - weakness in both legs. For example, with multiple sclerosis, myelopathy, polyneuropathy( diabetic, alcoholic), Stryumpel's disease. With these diseases, too, the gait is disturbed.

A heavy gait - with edema of the legs, varicose veins, blood circulation in the legs - a person stomps hard, barely lifting baking legs.

Gait disturbances are always a symptom of a disease. Even the common cold and asthenia changes the gait. The lack of vitamin B12 can give numbness in the legs and disrupt the gait.

To which doctor to apply for violations of gait

For any violation of the gait, you need to see a doctor - neurologist, traumatologist, therapist, otolaryngologist, ophthalmologist, angio-surgeon. It is necessary to examine and treat the underlying disease that caused a gait disturbance or to adjust the way of life, the habit of sitting at the table "leg to foot", to diversify the sedentary lifestyle with physical culture, swimming pool, fitness, aqua aerobics, walks. Useful courses for multivitamins in group B, massage.

Doctor's consultation on gait disturbance:

Question: How to sit properly at the computer so that the spine does not develop scoliosis?
Answer: