Gait changes in various diseases. Gait disorders

The main musculoskeletal organ in the skeleton is the spine, it consists of several sections: cervical, thoracic, lumbar, sacral and coccygeal. Each of them has a certain number of vertebrae, between which, to cushion (reduce pressure and friction), there is an intervertebral disc. Cervical osteochondrosis is a disease that develops as a result of structural degeneration of the cervical vertebrae.

• Prevention of depression in osteochondrosis of the neck
• Preventive measures for cervical osteochondrosis

The reasons for the development are spinal injuries, a sedentary lifestyle, and with age, the structure of the cartilage located under and above the vertebral body becomes denser. And since it feeds the intervertebral disc, it, in turn, loses its basic properties.

Pain syndrome. Headaches, discomfort in the neck, migraines, etc. On the sides, in each vertebra there is a hole for the spinal nerves, the more tightly the intervertebral disc is pressed against the vertebra, the smaller the hole for the nerve, which leads to its infringement, and causes pain in osteochondrosis ...

Numbness in the fingers. The second most important in the diagnosis of cervical osteochondrosis. You can independently find out between which vertebrae the process takes place. With numbness of the ring finger and little finger - between 7 and 8 vertebrae, if the middle and ring finger - between 6 and 7 vertebrae, and with numbness of the thumb, index and middle fingers - between 5 and 6 vertebrae.

Disorders of a vestibular nature. Dizziness, unsteadiness and lack of coordination while walking. On the sides of the cervical vertebrae runs an artery that feeds the brain. Its name defines the performing function - vertebral. When it is pinched, the nutrition of the parts of the brain, namely the vestibular apparatus, is partially disturbed.

Also, cervical osteochondrosis and dizziness is manifested in the following:

• insomnia, lack of deep sleep;
• the development of depression;
• chronic tinnitus;
• inability to turn the neck to the end;
• increased fatigue;
• insecurity and panic attacks;
• emotional lability.

Most of the symptoms are due to an anatomical defect resulting from vertebral degeneration. But there are others, such as depression, which are not related to this.

Depression is a mental condition in which the body does not receive enough serotonin and dopamine. Clinically, it manifests itself in a pessimistic mood, constantly depressed mood, impaired thinking, inhibited reaction.

With cervical osteochondrosis, it has a chronic course, therefore, it is more often corrected with the help of antidepressants prescribed by a specialist. Chronic aching and persistent pain in the neck and headaches are the main factor in the development of depression in cervical osteochondrosis.

• With an acute manifestation of pain, the body spends a large amount of resources to eliminate it, and with constant pain, there is simply not enough resources, which is a stressful situation. And with prolonged stress, an exhausted body easily falls into depression.
• Unwanted job change due to inability to perform normal work.
• Constant tension and panic fear of new, more severe pains, dizziness and situations in which they may appear.
• Taking drugs that cause additional pain in the stomach and liver. And drugs that have a side effect of a state of depression.

First, you need to understand that this is a state of chronic course, so if the mood deteriorated, and then a few hours later improved again, then it was not depression. The "triad" is taken as a basis: low mood, impaired thinking, retardation in movements and reactions.

The following signs are:

1. Decreased interest in entertainment, pleasures of life.
2. Suicidal thoughts and sayings.
3. Apathy.
4. Poor concentration on the task.
5. Low self-esteem
6. Self-flagellation.
7. Inhibited motor and mental activity.
8. Absent-mindedness and confusion, uncertainty in every act
9. Decreased libido.
10. Sleep disturbance, insomnia
11. Increased anxiety and constant fear.

Worst case of depression, suicide attempt. It is important to monitor your condition, or if a relative is diagnosed, then follow it, since most often, an attempt at suicide is only a way to attract attention to yourself, and not a desire to go to another world.

Once a specialist has diagnosed depression, treatment should be started immediately. The body is simply stuck in a vicious circle: with depression, the production of serotonin decreases, which provides an analgesic effect. The usual pain increases, which leads to an even greater depression. Therefore, you have to start taking antidepressants.

Prevention of depression in osteochondrosis of the neck

It is necessary to be examined at the first manifestations of back pain and a feeling of discomfort, a hint of cervical osteochondrosis. It is also recommended to increase physical activity while sedentary. The following steps can be taken to prevent depression:

The development of panic attacks associated with impaired microcirculation of the brain. Unfortunately, this is a very formidable symptom, informing that the cerebral cortex is already affected and is not coping with its function. It is necessary to contact a specialist as soon as possible.

Separately, it should be noted such a symptom as dizziness with cervical osteochondrosis. It appears as a result of malnutrition of the brain, as well as panic attacks, unsteadiness of gait and other vestibular symptoms.

As a rule, it is impossible to predict the manifestation of dizziness in advance, so you need to carefully monitor your feelings and sensations so as not to be without help at a difficult moment. If a relative has a disease, then you should not leave him alone for a long time at work or other physical activity.

Cervical osteochondrosis, unfortunately, is a chronic disease. And in order to achieve the maximum effect of the treatment, it is necessary to carefully observe the sparing regimen and the use of medications prescribed by a specialist.

Go for massage and physiotherapy. And in no case self-medicate. You can try to see a chiropractor. Thanks to his work, it is possible to reduce pain, which will improve the quality of life and prevent the development of fear and depression.

Cervical osteochondrosis prevention measures

When performing these simple steps, it is possible to prevent the appearance of a disease that will not heal later. Everyone's health depends on himself.

Staggering gait is not a diagnosis, but a symptom that is a manifestation of a disease. Therefore, when it appears, you should immediately consult a doctor for examination.

The main reason is vasospasm, which is caused by tension in the muscles of the back, in particular the neck. This often happens with increased anxiety and tension. In this case, the main treatment should not be medication, but carried out with the help of sessions with a psychotherapist.

Another common cause of fragility is cervical osteochondrosis, which is diagnosed very often these days. Dizziness and darkening of the eyes may be added to this symptom. This happens due to the incorrect position of the vertebrae, which constrict the vessels, and the blood cannot enter the brain in the required amount, because of which its cells remain without oxygen, which is reflected in the manifestation of a variety of symptoms.

However, the causes of unsteadiness when walking can be more serious. So, for example, diseases for which this symptom is characteristic can be considered:

1. Early cerebellar ataxia.
2. Late neurosyphilis.
3. Huntington's disease.
4. Cerebellar tumors.
5. Meningeal tuberculosis.
6. Acute disseminated encephalitis.
7. Meningitis.
8. Candidal meningitis.
9. Arnold-Cairo anomaly.
10. Hemorrhagic stroke.
11. Brain abscess.
12. Medicinal polyneuropathy.

But this is not the whole list of reasons that can cause unsteadiness of gait, therefore, to make the correct diagnosis, as well as to prescribe treatment, you must definitely consult a doctor.

In appearance, this state can be divided into systemic and non-systemic. The first type includes lesions of the vestibular and auditory apparatus, as well as diseases of the brain and spinal cord. Non-systemic manifestations are the consequences of chronic diseases of the heart, blood vessels, endocrine and respiratory systems.

The essence of the disease

Shaky gait without dizziness is a frequent manifestation of osteochondrosis. This is a dystrophic disease of cartilage and bone tissue, which manifests itself mainly in adulthood. The disease is based on dystrophy of the intervertebral discs. All this negatively affects the blood supply, nutrition and hydration of the intervertebral disc. And the ensuing deformation leads to a strong narrowing of the space between the vertebrae.

Due to the decrease in the intervertebral space, the spinal nerves can be pinched. The main symptoms of such an infringement will depend on where it happened - in the cervical, thoracic or lumbar spine. If it is a neck, then the main manifestations are headache, dizziness and other manifestations associated with a malnutrition of the brain. If it is the thoracic spine, pain in the region of the heart may appear that resembles symptoms of myocardial infarction or angina. And if this is the lower back, then the symptoms can be in the form of impaired mobility in the legs, their weakness and a decrease in skin sensitivity.

Therefore, dizziness and unsteadiness of gait can be the cause of such an insidious disease as osteochondrosis. Due to the compression of the nerve root, the conduction of the impulse along it to the muscles of the legs is disturbed, and this can be either one leg or both. This is the reason for the appearance of weakness in the legs.

What to do

The unsteadiness of gait with osteochondrosis is a rather dangerous sign that you need to immediately pay attention to and go to the doctor's office. This is especially dangerous when weakness in the legs gradually increases. But before starting treatment, you need to undergo a comprehensive examination so that the doctor can understand what caused this pathology, and why this symptom appeared.

When a pain syndrome appears, it must be removed with the help of anesthetic drugs. Here you can use not only one drug, but also a mixture of several components. For example, solutions can be as follows:

1. Analgin + no-shpa + lasix + novocaine. All this is added to 150 ml of 0.9% sodium chloride solution and applied intravenously.
2. Baralgin + Relanium + Dexazon + Novocain. All this is injected into a 5% glucose solution in an amount of 200 ml and also dripped as an intravenous infusion.
3. Analgin + vitamin B12 + no-shpa + reopirin. All drugs are mixed in one syringe and injected intramuscularly.

The unsteadiness of gait with osteochondrosis is a symptom that requires the appointment of other drugs, for example, pentoxifylline, which improves blood circulation, theonicol or nicotinic acid, and drugs that will stimulate blood flow through the veins. Of course, one must also remember about the fortifying effect of vitamin and mineral complexes, which help to replenish the balance of nutrients in the body.

Walking this is one of the most difficult types of physical activity. Cyclic stepping movements trigger the lumbosacral centers of the spinal cord, regulate the cerebral cortex, basal nuclei, brain stem structures and cerebellum. This regulation involves proprioceptive, vestibular, and visual reverse afferentation. The human gait is a harmonious interplay of muscles, bones, eyes, and inner ear. The brain and central nervous system are responsible for coordinating movements. With violations in the parts of the central nervous system, various movement disorders can occur, namely:

shuffling gait;

sharp jerky movements;

difficulty flexing joints

Gait disorders

Abasia also dysbasia is a gait disorder or inability to walk due to gross gait disturbances. In a broad sense, the term abasia means gait disturbances in lesions involving various levels of the motor act organization system, and includes such types gait disturbancesas:

atactic gait;

hemiparetic;

paraspastic;

spastic-atactic;

hypokinetic gait.

In addition, experts distinguish gait apraxia (frontal dysbasia), idiopathic senile dysbasia, peroneal gait, duck gait, gait with pronounced lordosis in the lumbar region, hyperkinetic gait, gait for diseases of the musculoskeletal system, dysbasia in case of mental retardation, dementia, psychotic iatrogenic and drug dysbasia, gait disturbances in epilepsy and paroxysmal dyskinesia.

In neurology, there are dysbasia:

Frontal (gait apraxia);

senile;

psychogenic.

Frontal dysbasia can occur as a result of stroke, discirculatory encephalopathy, normotensive hydrocephalus, dysbasia in neurodegenerative diseases, senile dysbasia, and gait disturbances observed in hysteria (psychogenic dysbasia).

The eye and inner ear play a role in causing gait disturbance. Older people with visual impairment develop gait disorders. A person with an infection of the inner ear may develop balance disorders that can lead to gait problems.

One common source of gait disturbances is functional disorderscentral nervous system. These can be conditions associated with the use of sedatives, alcohol and drug abuse. Poor nutrition appears to play a role in gait disturbances, especially in the elderly. Vitamin B12 deficiency often causes limb numbness and imbalance, leading to changes in gait. Finally, any disease or condition in which nerves or muscles are damaged can cause gait disturbances.

Gait disorders in diseases

More serious lesions with gait changes include:

amyotrophic lateral sclerosis (Lou Gehrig's disease);

multiple sclerosis;

muscular dystrophy;

parkinson's disease.

Diabetes often causes numbness in both legs. Many people with diabetes lose the ability to determine the position of their feet in relation to the floor. Therefore, they have an unstable position and gait disturbances. If there are no neurological symptoms, the cause of the gait disturbance is difficult to find out even for an experienced doctor.

Hemiplegic gait is observed with spastic hemiparesis... In severe cases, an altered position of the limbs is characteristic: the shoulder is brought and turned inward, the elbow, wrist and fingers are bent, the leg is unbent at the hip, knee and ankle joints. The step of the affected leg begins with the abduction of the hip and its movement in a circle, while the body deviates in the opposite direction. Hemiplegic gait possible impairment after stroke.

Types of gait disorders

When paraparetic gait the patient rearranges both legs slowly and tensely, in a circle - the same as with hemiparesis. Many patients have their legs crossed when walking, like scissors. Paraparetic gait is observed with damage to the spinal cord and infantile cerebral palsy.

The so-called "cock walk" is caused by insufficient dorsiflexion of the foot. When stepping forward, the foot hangs partially or completely, so the patient is forced to raise the leg higher so that the fingers do not touch the floor. A unilateral disorder occurs with lumbosacral radiculopathy, sciatic nerve neuropathy or peroneal nerve; bilateral with polyneuropathy and lumbosacral radiculopathy. Duck gait is explained by the weakness of the proximal muscles of the legs and is usually observed with myopathies, less often with lesions of the neuromuscular synapse or spinal amyotrophy.

When akinetic-rigid gait the patient is usually hunched over, his legs are bent, his arms are bent at the elbows and pressed to the body, pronation-supination tremor of rest (with a frequency of 4-6 Hz) is often noticeable. Walking begins by leaning forward. This is followed by mincing, shuffling steps - their speed is steadily increasing, as the body "overtakes" the legs. This occurs when moving both forward (propulsion) and backward (retropulsion). Having lost balance, the patient may fall.

Apraxic gait observed in bilateral lesions of the frontal lobe due to impaired ability to plan and execute a sequence of actions. The apraxic gait resembles a parkinsonian gait - the same "petitioner posture" and mincing steps - however, a detailed study reveals significant differences. The patient easily performs the individual movements required for walking, both lying down and standing. But when he is offered to go, he cannot budge for a long time. Having finally made a few steps, the patient stops. After a few seconds, the attempt to walk is repeated.

When choreoathetic gaitthe rhythm of walking is disturbed by sharp, violent movements. Due to the chaotic movements in the hip joint, the gait looks "loose".

When cerebellar gaitthe patient spreads his legs wide, the speed and length of steps are constantly changing. When the medial zone of the cerebellum is affected, a "drunk" gait and ataxia of the legs are observed. The patient maintains balance both with open and closed eyes, but loses it when changing posture. The gait may be fast, but it is irregular. Often when walking, the patient experiences uncertainty, but it goes away if he is even slightly supported. With damage to the cerebellar hemispheres, gait disturbances are combined with locomotor ataxia and nystagmus.

Gait at sensory ataxia resembles a cerebellar gait - legs wide apart, loss of balance when changing posture.
The difference is that when the eyes are closed, the patient immediately loses balance and, if not maintained, may fall (instability in the Romberg position).

Gait vestibular ataxia. With vestibular ataxia, the patient always falls to one side - regardless of whether he is standing or walking. There is clear asymmetric nystagmus. Muscle strength and proprioceptive sensitivity are normal — in contrast to unilateral sensory ataxia and hemiparesis.

Gait disorder can be with hysteria. At the same time, the patient maintains coordinated leg movements: both lying and sitting, but he cannot stand and move without assistance. If the patient is distracted, he maintains balance and takes a few normal steps, but then demonstratively falls - into the hands of the doctor or onto the bed.

The so-called duck gait can be a sign of serious hip disease. In this article, we will talk about what kind of diseases this pathology can be in adults and children. And also consider the reasons for the appearance of such a gait in pregnant women.

Causes of pathology in adults

"Duck gait" is typical for diseases, in particular coxarthrosis.

This disease is chronic and leads to the gradual destruction of the bone tissue that forms the hip joints. There are many reasons for the pathology, but the main one is considered to be permanent injury to the musculoskeletal system. The development of the disease leads to the fact that the joint space begins to narrow. In the last stages of the disease, it may disappear completely.

In adults, the "duck gait" (the causes of the disease in children will be discussed below) can be caused mainly only by coxarthrosis. This pathology can develop in people of any age, with the exception of very young children. Men suffer from it more often than women. This is due to the fact that their physical activity is usually higher. Elderly people are most susceptible to coxarthrosis. At this age, tissue nutrition begins to be disrupted, and the body's ability to recover decreases.

How coxarthrosis develops

So, "duck walk" in what disease appears in adults? Basically, with coxarthrosis, since it can only be caused by the destruction of the joints. But how does it happen and where does it start? How not to start the process and start treatment on time?

Regardless of what caused the appearance of the disease, it will always develop according to the same pattern. Healthy joint surfaces always match each other so that the load is evenly distributed. However, due to various harmful effects, deformation of the main component of the articular cavity occurs. This leads to a violation of the congruence of the articular surfaces. And this already results in an uneven distribution of the load on the joint during movement. The part of the cartilage that carries most of the weight gradually deforms and even cracks. And the surface of the joints becomes rough and uneven.

This process entails compensatory responses. First, cartilage begins to grow in the damaged area. If the load does not decrease, then it gradually dies, and a bone is formed in its place. This leads to the formation of osteophytes (bony outgrowths), which gradually fill the joint. Around this time, the "duck walk" appears. It indicates the advanced state of the disease. If you do not start treatment on time, then the joints can finally lose their mobility.

The causes of the disease

The cause of coxarthrosis can be:

• Degenerative senile changes.
• Dysplasia is a congenital pathology (we will talk about it in more detail below).
• Injuries.
• Infectious diseases that cause damage to the musculoskeletal system.
• Aseptic necrosis of the femoral head.
• Perthes disease.

There is also idiopathic coxarthrosis, the cause of which is still unknown to medicine.

Symptoms accompanying joint destruction

The danger of coxarthrosis is that it is diagnosed at an advanced stage. The fact is that in the affected areas there is no swelling of tissues, various swellings, etc.

Let's list the main symptoms of the disease:

• Limitation of joint mobility - this symptom appears quite early, but it can also be a symptom of another disease. Its cause is the narrowing of the joint space.
• Distinct "crunch". It appears due to the friction of the joints against each other. As the disease develops, the volume of the sound produced will increase.
• Painful sensations. They appear due to damage to the intra-articular structures and a decrease in the amount of intra-articular fluid. The stronger the friction, the more pain the patient will feel.
• Muscle spasms. They are due to the weakening of the joint capsules.
• Shortening of the affected leg. Appears already in the later stages. The leg on the side of the affected joint may be 1-2 cm shorter than the healthy one.
• Duck gait is another symptom that appears in the later stages. And it belongs to the extremely unfavorable signs. The reason for the appearance is that, due to changes, a person can no longer maintain balance with the correct position of the legs. Gradually, the patient simply physically loses the ability to straighten the knee joints and stand up straight.

How to diagnose a disease before the appearance of a "duck walk"

"Duck gait" in itself is a serious clinical sign for the diagnosis. But at this stage, the treatment will already be ineffective, so it is better to start it much earlier. And for this you need to diagnose coxarthrosis at an earlier stage. To do this, there are a number of methods that should be used when the first signs appear. Let's list the main diagnostic tools:

• Computed tomography is much more effective than conventional X-ray, as it provides information on the quantity and quality of the joint tissue.
• X-ray examinations.
• Comparison of the length of the legs - this method is suitable only for the later stages, when serious degenerative changes in the joints have occurred.
• Magnetic resonance imaging.

Characteristics of gait in coxarthrosis

With this pathology, patients have two options for changing gait. The first appears when only one joint is damaged, the second when two are diseased. The last option is called "duck walk". Let's take a closer look at what is happening at this moment with the joints.

So, the wrong approach appears after the bone tissue in the articular cavities has begun to crack. At this moment, the "adductive contracture" begins to form, that is, the patient's legs take a slightly bent position inwards. And the patient can no longer return to a normal state on his own. During movement, a person is forced to transfer the weight of the whole body from one leg to the other. This is accompanied by swaying movements from side to side. That is why the gait is popularly called "duck".

However, such a serious change in the position of the musculoskeletal system is characteristic even for advanced stages of the disease. What is especially dangerous, such a transfer of the weight of the body leads to curvature of the spine and lesions of the knee joints. Therefore, doctors advise using crutches or walking sticks (two are required) to reduce stress.

"Duck walk" during pregnancy

A change in gait in a woman during pregnancy has nothing to do with coxarthrosis, and it is caused by completely different reasons. Usually, gait changes in late pregnancy, in the eighth or ninth month. Women really start to spread their legs wide and at the same time waddle a little from one leg to the other.

But still, let's find out the reasons for such changes. Of course, they depend on the physiological changes occurring in the female body:

• Weight gain, and therefore an increase in the load on the spinal column. The reason for this is also the lower back pain, which pregnant women so often complain about.
• The center of gravity is shifted. Pregnant women are a little disoriented in space, to which, of course, the body reflexively reacts and slightly changes gait for greater stability.
• When approaching childbirth, the joints of the pelvis become mobile.

In this case, there should be no pain in the hip joints. If they appear, then we can talk about symphysitis, then an urgent need to consult a doctor. Otherwise, nothing terrible happens. Gait change is a natural process.

What should pregnant women do when they have a duck gait?

Duck walk in women can be a real psychological problem. Expectant mothers are already emotionally vulnerable, and such a huge, from their point of view, flaw deprives them of any attractiveness. However, do not despair. As polls show, such a gait of pregnant women causes only tenderness and a lot of positive emotions in others.

Unfortunately, it is impossible to answer the question of how to get rid of the "duck gait" during pregnancy. We'll have to wait for the birth. As soon as the child is born, the same step will return to you. A brace can slightly ease the position, which will reduce the load on the spine. But this will not bring any drastic changes.

"Duck walk" in a child

The cause of pathology (dysbasia) in a child may be changes of an orthopedic or neurological nature. These changes can be caused by diseases of the central nervous system and peripheral, as well as diseases and congenital defects of the joints. There are more than 20 variants of gait disturbance, but "duck" is the most common.

This type of pathology is characterized by the shifting from foot to foot already described above. And the reason for its appearance is changes in the hip joints, accompanied by pain. This gait not only causes discomfort, but also leads to other disorders of the musculoskeletal system.

Causes of "duck gait" in children

In 90% of cases, a "duck gait" appears in a child with dysplasia, pathological changes in the hip joints. This ailment leads to pseudoarthrosis and chronic dislocations.

Dysplasia is a very common condition that affects 3% of all newborns. And in 80% of all cases, girls suffer from ailment. If the pathology was discovered in infancy, you can try to correct it with the help of special bandages.

Also, the cause of the "duck gait" can be inflammatory processes in the nerves of the lumbosacral plexus or sacroiliac joint.

Treatment of children

"Duck gait" in a child indicates the presence of a rather serious abnormality that needs to be diagnosed and treated.

The therapeutic complex will depend only on the cause of the disease. As noted above, in some cases, with an early diagnosis, it is possible to completely get rid of such a gait. But it all depends on the specific case, the speed of assistance and the qualifications of the specialists who prescribe the treatment.

Exercises to correct gait

Exercises to correct the "duck gait" in case of illness should be carried out only after consultation with the attending physician. Here we do not consider cases with pregnant women and children, since this is a completely different category, and the exercise therapy complex should be developed individually for them.

• Lie on your back, relax, start slowly alternately bending your legs at the hip and knee joints, trying to press the knee to your chest.
• Lie on your stomach. Lift your right leg, then your left, then both. In this case, the legs should be straight and not bend at the knee joints.
• Lie on your back and begin to spread your legs to the sides, returning to the starting position.

These exercises are designed not to load the diseased joint, but to develop it. No need to rush, do all tasks very slowly. Don't overload your legs. If pain occurs, the complex must be interrupted. Don't do all the exercises at once. First, master the first, then after a couple of days connect the second, and so on. You can gradually increase the number of approaches, but only in the absence of discomfort in the joints. It takes a lot of patience and perseverance, but the result is worth the effort.

A wobbly gait is a rather alarming symptom that may indicate the presence of a serious pathology of the brain, nervous system, or musculoskeletal system. Young children also experience some imbalance in walking when they learn to walk, but this will go away over time. If such a symptom occurs at an older age, you need to go to the hospital as soon as possible for an examination and identify the problem.

Manifestations

With normal coordinated functioning of the bone, muscular and ocular systems, as well as the inner ear and nerve trunks, there are no problems with gait. But as soon as at least one of these elements fails, disturbances arise in the form of a wobbly gait. Sometimes these deviations are practically invisible, but there are cases when a person, due to such a condition, practically cannot move in space. His gait becomes unstable, unsteady.

There are many reasons for this symptomatology. Therefore, it is worthwhile to understand in detail at what diseases a person has a similar symptom.

Causes of shaky gait

Coordination disorders are a rather dangerous symptom. Therefore, if you experience gait disturbances, you should immediately consult a doctor. A shaky gait can signal problems such as:

• Cerebral palsy.
• Diseases affecting the musculoskeletal system (muscle tissue, joints, bones, tendons).
• Lack of vitamins B1, B12, folates.
• Neoplasms in the brain.
• Poisoning with alcohol and narcotic and psychotropic substances.
• Diseases affecting the brain and spinal cord.
• Hemorrhagic and ischemic strokes.
• Traumatic brain injury.
• Varicose veins, thrombarteritis obliterans.
• Myasthenia gravis and multiple sclerosis.
• Fainting conditions.

An unsteady gait can occur when wearing uncomfortable shoes.

Diseases of the brain and spinal cord

When a person is healthy, he does not have the question of how to maintain balance in an upright position, since this function is automatically regulated by the vestibular apparatus and the muscular system. Impaired coordination of movements, including gait, can occur in diseases of the spinal cord and brain. These organs are responsible for the functioning of the central nervous system, therefore, the diseases associated with them lead to this kind of disorders. A patient with disorders of the vestibular apparatus has a wobbly gait, dizziness, instability of the trunk and other symptoms.

When the brain is damaged, the organ is not able to send certain signals and control neural processes, and this directly affects the work of the lower limbs.

What pathologies of the brain and spinal cord can lead to coordination disorders?

1. Atherosclerosis.
2. Hemorrhagic stroke.
3. Meningitis.
4. Oncological diseases.
5. Inflammatory and purulent processes in the brain.
6. Abnormalities in the location and structure of the "small brain" (cerebellum).
7. Functional disorders in the work of the central nervous system.
8. Neurodegenerative diseases arising on the background of mental disorders or hyperkinesis.
9. Infection with pale treponema, subsequently affecting the central nervous system.
10. Encephalomyelitis.
11. Parkinson's disease.

Inflammatory processes in the inner ear can also lead to poor coordination. To avoid complications, you must consult a doctor in a timely manner. He will conduct a thorough examination and prescribe treatment. Misuse of neurotoxic drugs can also cause shaky gait. An overdose of such drugs leads to the development of polyneuropathy, one of the symptoms of which is coordination disorders.

Musculoskeletal system disorders

There are many pathologies of the musculoskeletal system in which a person may experience a wobbly gait. These include:

• osteochondrosis;
• arthritis;
• osteomyelitis;
• arthrosis, etc.

Inflammatory processes and degenerative changes occurring in the joints lead to painful sensations. To alleviate the condition, a person tries to reduce the load on his legs as much as possible, which is why his movements when walking become asymmetric.

For example, with osteochondrosis, afferent and efferent fibers (connect the brain with other parts of the body and organs) that go to the lower extremities are impaired. Due to pinching of the nerve roots, muscle tissue and their sensitivity are weakened.

A shaky gait symptom can also occur after a fracture of the lower extremities. During the period while the leg was plastered, the muscle tissues did not function properly, that is, they did not participate in movement, which led to their atrophy. Until the muscles adapt and return to normal, the patient will experience unsteadiness and asymmetry in gait.

Impaired coordination of movements can occur with sprains and tendon ruptures, as well as with paralysis of muscle tissues.

Neuroses and mental disorders

A symptom such as a wobbly gait can occur with various mental disorders and pathologies of the nervous system. These include stress and depressive conditions, nervous breakdowns, neuroses. Also, a violation of coordination can be observed in violation of the perception of the surrounding reality, in the presence of groundless fears and anxieties.

Alcohol intoxication of the body

The use of alcohol, narcotic and psychotropic drugs leads to intoxication of the body and disruption of the central nervous system, which is why such a symptom as a wobbly gait occurs.

After the toxic substances enter the digestive system, they are absorbed into the bloodstream and are carried by the bloodstream to all organs. These substances penetrate into muscle tissue and the brain, including the cerebellum, which is responsible for the coordination of movements. The maximum concentration of a substance in the blood is observed 20 minutes after taking alcohol or drugs.

In women, the intoxicating effect is much more pronounced than in the stronger sex. It's all about the characteristics of the body. Women have more adipose tissues, and as you know, alcohol-containing substances do not dissolve in them. Since with alcohol intoxication, the muscular system first of all weakens, therefore, the manifestations of poisoning in the fairer sex are more pronounced.

In the process of alcohol decomposition, a very harmful, poisonous substance is released - acetaldehyde. It negatively affects the functioning of the cerebellum, which leads to impaired coordination. In a drunken person, the look becomes cloudy, a wobbly gait is observed while walking, etc. With severe intoxication, headache, nausea and urge to vomit may also occur.

Diagnostics

If a wobbly gait occurs, you should immediately consult a doctor, as this symptom can hide a very serious illness. After examining the patient and assessing his general health, the specialist prescribes additional diagnostic measures that will help to make the correct diagnosis. Depending on the concomitant symptoms, the following may be prescribed:

• consultation of narrow specialists: otolaryngologist, neurosurgeon, etc .;
• MR angiography;
• electroencephalography;
• toxicological examination;
• general and biochemical blood test;
• analysis to determine the concentration of vitamin B12 in the blood.

Treatment

As such, a wobbly gait is not treated as it is just a symptom. First of all, the doctor must determine what disease led to the impairment of the functions of coordination of movements, and only then choose an effective therapy.

The spectrum of diseases in which such symptoms occur is very large. Accordingly, there are many treatment methods. For instance:

• Pathologies of the musculoskeletal system are treated with chondroprotectors "Mukosat", "Dona" and others, as well as physiotherapy. Additionally, complexes of minerals, muscle relaxants are prescribed.
• If a shaky gait is due to a lack of B vitamins, experts recommend taking drugs such as Milgamma, Neuromultivit, Combilipen, etc. These funds have a beneficial effect on the nervous system.
• In multiple sclerosis, glucocorticoid hormones, immunosuppressants, are used that suppress autoimmune reactions.
• For more serious pathologies, such as brain tumors and other serious conditions, they resort to surgical intervention.

Health

As soon as any person takes a few steps, the trained eye of some specialists will instantly be able to tell a lot about this person, or, more precisely, about his / her state of health. According to relevant experts, practically everything when walking - gait, manner of movement, posture, steps - can provide a lot of interesting information about the general state of human health.

“Many doctors are absolutely sure that, looking at a person walking along the road, one can even diagnose him. There is an opportunity to find out whether a person is healthy or not, and if he is not healthy - identify a few telltale signs that will indicate a specific problem" says Charles Blitzer, an orthopedic surgeon and spokesman for the American Academy of Orthopedic Surgeons. We bring to your attention 15 specific signs that characterize a person's gait and tell about his health.

1. Specific sign: sluggish and slow pace

What does this mean? Short life expectancy

The speed at which a person walks is considered by some to be a reliable indicator of how long a given individual will live. Scientists from the University of Pittsburgh summed up nine studies in which 36,000 people over 65 took part... In fact, it was predicted how much a person would have left and these predictions were confirmed by subsequent analysis of the person's age, chronic diseases, body mass index, and so on.

The average speed at which people walked was 3 steps per second (approximately 3 kilometers per hour). Those who walked slower than 2 steps per second (two kilometers per hour), the risk of sudden death was much higher in the coming years... Those who walked with a frequency of more than 3.3 steps per second (almost 4 kilometers per hour) lived longer, regardless of age, gender, and some other characteristics.

In 2006, the following information appeared in the Journal of the American Medical Association: if a person, being between the ages of 70 and 79, is not able to walk a distance of half a kilometer at once, he has a great chance of leaving this world in the next six years... An earlier study of men between the ages of 71 and 93 found data showing that those who can walk three kilometers a day are half as likely to suffer a heart attack as those who can walk three kilometers a day. who cannot walk even five hundred meters.

Unfortunately, trying to start walking faster and walking longer will not suddenly make these people healthier. On the contrary, such activity in old age can even increase the risk of injury, so you should think about it long before old age... One thing is clear: in old age, the human body itself determines the most suitable movement speed for it, based on its own state of health. And if this rate is low, it usually indicates concomitant health problems that negatively affect life expectancy.

2. Specific sign: not wide waving of the arms when walking

What does this mean? Lower back problems

According to physiotherapist Steve Bailey, owner of a medical center in Knoxville, Tennessee, the human body has an extremely amazing structure. In particular, Bailey noted the fact that when we put the left hip forward when walking, the spine makes a certain movement and the right upper limb moves back. This coordinated muscle function in both parts of the body is necessary to support the lower back.

If, when walking, a person practically does not demonstrate specific flapping movements of the upper limbs (or if these movements are weakly expressed), this is an alarming sign. In particular, this suggests that the spine is not provided with the necessary support due to a certain limited mobility of the lumbar region or back. Bailey believes that hand flapping is an indicator of the functioning of our dorsal regions.

3. Specific sign: one leg slaps heavily on the floor when walking

What does this mean? Spinal disc injuries, as well as a possible sign of a stroke

Some professionals do not need to see a person walking in order to determine their health problems. It is enough for them to hear him / her walk! A phenomenon called drooping (drooping) feet, or "flapping feet" indicates that you literally drop your foot to the ground when walking... According to orthopedic surgeon Jane E. Andersen, former president of the American Association for Women Podiatrists, there may be a weakening of the tibialis anterior muscle.

That is to say, correct walking of a healthy person begins with lowering the heel to the ground, after which the rest of the foot smoothly drops to the ground. Then the initiative to lift and lift the foot shifts from the big toe to the heel. However, with a sagging foot, the person loses control over the muscles and the foot is not able to smoothly return to the ground. Instead, she just plops on top of her.

"This may indicate a stroke or some other neuromuscular pathology, or a pinched nerve.", explains Andersen. A fairly common cause is damage to the lumbar disc, since this is a compression of the nerve that extends into the lower limb... Another, more rare cause that leads to the phenomenon of a sagging foot is a pinched peroneal nerve.

4. Specific sign: confident open gait (in women)

What does this mean? Ability for sexual satisfaction

Not only health problems can be identified by gait. In 2008, in the European scientific publication "Journal of Sexual Medicine" were published the results of one of the studies conducted by Belgian and Scottish scientists... As part of this study, it was found that a woman's gait did indeed signal her ability to easily achieve sexual gratification.

In other words, if a woman has a smooth, but at the same time, energetic gait, then there is a high probability that such a woman is quite easily able to achieve a vaginal orgasm. To come to a similar conclusion, the researchers compared the gaits of those women.who really achieve orgasm only through vaginal penetration (without clitoral stimulation), with the gaits of women who find it difficult or almost impossible to achieve orgasm only through vaginal stimulation.

Well, there is dependence, but what is the rationale behind this connection? What is the scientific explanation for this phenomenon? According to one theory, regular orgasm affects the muscles, that become neither weak nor too tight... As a result, such a woman demonstrates a freer and lighter gait, which looks quite harmonious against the background of constant sexual satisfaction and increased self-esteem.

5. Specific sign: mincing gait

What does this mean? Degeneration of the knee or hip joint

When the heel touches the ground at the very beginning of the stride, the knee joint should normally be extended. If this is not the case, the result is travel length problems. In other words, what happens impaired ability of the knee joint to move properly within the kneecap. "Degenerative changes in the patella sometimes lead to the need for manual therapy that develops the joint and improves range of motion."says physiotherapist Steve Bailey.

A similar problem with mincing gait can be attributed to insufficient hip extension. When a person takes small steps, he, in principle, does not need a significant extension of this joint. "Unfortunately, this tactic leads to an increase in pressure on the back" Bailey says. According to the doctor, when the hip joint is not fully extended, it subsequently limits the mobility of other joints, leading to back pain and, for example, to the same sagging foot.

6. Specific sign: lowering of the pelvis or shoulder from either side

What does this mean? Spine problems or insufficient hip abductors

The so-called abductor muscles, called abductors (located on the outer thighs), actually support the pelvis with every step we take. In other words, when we raise one limb and move it forwardresting on the other limb, the abductors support the body in a straight position. However, sometimes these muscles don't work properly.

So, abductors play the role of compensators when moving our body. Violation of their work leads to the so-called Trendelenburg symptom, when a person falls heavily when walking on one side. This occurs at the moment when the heel from the healthy side drops to the ground. The pelvis sags on this side, trying to compensate for the lack of strengthwhich the muscles on the other side must produce. Sometimes this sag is so pronounced that the entire half of the body sags along with the shoulder. The terminal stage of this disorder is manifested in problems with the spine.

7. A specific feature: legs with a wheel ("cavalry" gait)

What does this mean? Osteoarthritis

"Just imagine the classic image of an elderly, slow cowboy with crooked legs- says orthopedic surgeon Blitzer. - Perhaps the reason for this is arthritic knees." ... Indeed, approximately 85 percent of people with osteoarthritis (especially those suffering from the most physically damaging senile form of the disease) have a "cavalry" gait.

O-shaped curvature of the legs (or simply O-shaped legs) is a consequence of the fact that the human body cannot be supported properly, which literally leads to the outward curvature of the knees. The cause of the "cavalry" gait may be a disease such as rickets, or even a certain combination of genes. However, these reasons most often appear even in childhood. Timely intervention and special braces can help correct this condition.

8. Specific sign: knees turned inward

What does this mean? Rheumatoid arthritis

Rheumatoid arthritis is an inflammatory disease, which indeed very often can be expressed in "X-legs", that is, when knees literally twist inward towards each other. "About 85 percent of people with rheumatoid arthritis have inverted knees.", - states orthopedic surgeon Charles Blitzer.

With "legs X", the legs lose their straight position, striving inward. In this case, the person demonstrates a specific awkward gait, when the knees are too close to each other, and the ankles, on the contrary, are significantly spaced from each other. In some cases, osteoarthritis can manifest itself in a similar disorder, depending on which joints are damaged.

9. Specific sign: shortening of stride when cornering and maneuvering

What does this mean? Poor general physical condition

Balancing is a coordination function between three systems: vision, the inner ear, and what is called proprioception, the ability of joints to communicate their position to the brain. A similar opportunity for joints due to the presence of receptors in the connective tissues between them... However, the performance of these receptors depends on how many movements the joints perform. "If you are an active person, more receptors are functioning in your connective tissue, therefore your proprioception is better."Bailey explains.

In fact, this means that you are better at keeping your balance. This is why a sick or physically frail person has balance problems. "If you have balance problems, you take smaller steps, which is especially noticeable when cornering or when maneuvering around various objects... It can also be problematic to move for a long time, as this requires balancing on each leg for a longer amount of time. At the same time, you feel much more confident on a straight section "Bailey says.

Orthopedic surgeon Charles Blitzer recommends people who need a support cane for walking due to illness, but are not in a hurry to resort to its help for fear of looking old, discard prejudice and pride. "Better to start using the appropriate adaptation devices and continue to be active rather than being motionless, which is a kind of vicious circle making you even more motionless. "- says Blitzer.

Among other things, problems with maintaining balance can be associated with peripheral neuropathy, a certain type of damage to nerve endings, caused by a disease such as diabetes... In addition, American podiatrist Jane Andersen names alcohol dependence and lack of vitamins as other possible causes of imbalance.

10. Specific sign: "flat" gait with low elevation of the legs

What does this mean? Flat feet, bunion, neuroma

It seems that flat feet are easy to determine at first glance: in a person who has this phenomenon, practically a peculiar arch is not visible on the inner part of the foot, which makes the foot appear flat... Actually, therefore, this phenomenon is called flat feet. However, a shuffling gait is also possible for other reasons.

When a person is about to take a step, his foot is straightened just at the moment when the heel comes off the floor. Then it takes the shape of an arch again. The heel also tends to the inside a little when the foot is lifted., and the thumbs can bend upward. All of the above complex movements are necessary in order to provide better stability.

Painful bursitis (an abnormal growth of bone or tissue near the base of the thumb) can sometimes be difficult. Another reason may be a violation of the nervous state of the foot (neuroma). The most common type of neuroma, called Morton's neuroma, is a painful thickening of the nerve between the third and fourth toes. This changes the way you walk, which makes the step less painful and traumatic.

11. Specific sign: shuffling

What does this mean? Parkinson's disease

Shuffling with the body tilted forward and against the background of serious efforts to lift the feet off the ground is an essential attribute of aging. This is a specific type of gait that may indicate that the person is suffering from Parkinson's disease. At the same time, the sick person makes small and uncertain steps. "Shuffling gait, which is one of the most common manifestations of this neuromuscular disease, is due to neuromuscular dysfunction."- explains Blitzer.

Another early sign of this disease is the appearance of tremors in the limbs. People who suffer from advanced dementia, such as Alzheimer's, may also be dragging their feet. In this case, we are talking about a violation of the cognitive process - the brain and muscles cannot communicate properly. Over time, memory loss is noted, and difficulties are observed with the implementation of the thought process (moreover, we can talk about the most elementary things).

12. Specific sign: walking on the tips of the toes of both feet

What does this mean? Cerebral palsy or spinal cord injury

Another notable gait is tip-toe walking. The tips of the toes reach the floor before the heel, although the opposite is usually the case. It is also associated with increased muscle tone caused by dysfunction of brain receptors. When a person steps on only the toes of both feet, it is almost always a violation of the upper spinal cord or even the brain (cerebral palsy or spinal cord injury).

You have probably noticed that young children who are just learning to walk very often stand on their toes and can even walk some distance on them. This is especially manifested when children pull their hands to someone or something.trying to stand on tiptoes. In this case, of course, we are not talking about paralysis. However, if you are overcome by anxiety and doubts, it makes sense to consult a doctor who can help you understand the situation.

13. Specific sign: walking on the tips of one toe

What does this mean? Stroke

Indeed, with this specific feature, everything is more or less clear. But this is only at first glance, since only doctors are able to determine the nature of the asymmetry, if a person, when walking, does not step with the full foot of one leg, but only with the tips of the fingers... In some cases, even when the situation seems obvious, it is far from always possible to unambiguously determine whether a person steps on the toes of one foot or both.

If this symptom is especially pronounced, it is highly likely that we are talking about the consequences of a stroke, in which the right or left side of the body is affected. However, I recall the situation with outbreaks in different parts of the world of such a disease as poliomyelitis. This disease literally drained and exhausted many people, and then a person could demonstrate a gait, in which he also stepped on the tips of one foot.

14. Specific sign: jumping gait

What does this mean? Overly tight calf muscles

One of the more unusual gaits is the one in which a person literally jumps up with each step. Experts often note that in this case, the so-called first phase of the normal step (when the heel begins to lift off the floor) happens too quickly due to the hardness of the calf muscles... Especially often this phenomenon is observed among female representatives, the reason for which, according to Andersen, is the constant wearing of high heels.

“I saw women in their 60s who were shown physical exercises - and, some of them for the first time in their lives. These exercises were necessary for them, but they could not do them for the simple reason that were unable to wear comfortable flat-soled shoes - says Andersen. - However, similar things can be observed much earlier in the life of women, at the age of 25. And all because girls begin to wear stiletto heels as early as adolescence ".

15. Specific sign: the arch of one foot is more pronounced and / or the thigh is slightly recessed

What does this mean? One leg is shorter than the other

The difference in the length of the limbs (in this case, the legs) can be identified by a specialist in several ways. However, most often it is enough to observe your step and examine your feet... According to podiatrist Jane Andersen, one foot usually looks flatter than the other. Typically, a flatter foot corresponds to a shorter leg.

Since the shorter leg has to travel a little further to reach the floor, the pelvis may sink slightly when walking, notes physiotherapist Steve Bailey. The doctor believes that you can independently see specific changes in the lumbar spine... To do this, you need to pay attention to the horizontal fold of the lumbar spine. From the side of the longer limb, this strip is, as it were, straightened, since the back is often extended there.

In principle, a person can be born with limbs of different lengths; or it may be due to knee cap or hip replacement surgery (if the limbs are not aligned as they heal after surgery). However, according to orthopedic surgeon Charles Blitzer, unless this difference exceeds two centimeters, this will not cause any particular negative health consequences. If the difference is not more than six millimeters, you can think about special inserts for shoes, and surgical intervention is considered as a solution to the problem with a larger difference.