Gait And Balance Problems
Numerous conditions can produce gait or balance disturbances. Balance and the gait pattern which humans use to walk are controlled from the cerebral cortex as well as reflexes to and from the peripheral nervous system. An event such as a stroke which damages the part of the brain that controls motor function will often affect the ability to walk and even balance oneself in sitting or standing. Other neurological conditions such as multiple sclerosis (MS) and Parkinson’s Disease can affect control of muscles and joints due to deficits in the nervous system. This in turn manifests as poor balance, altered gait, increased tone or stiffness, and weakness/fatigue.
Injuries to muscles and joints can also alter balance and gait. Strains, sprains, and chronic conditions such as degenerative osteoarthritis often lead to motor weakness and pain. Individuals then begin limping, shuffling, or compensating with other muscles in some way to still allow them to ambulate. Joint instability due to traumatic injury such as a ligament tear in the knee or ankle will also produce balance deficits.
Some medications have side effects related to loss of balance. This possible cause should always be considered when attempting to determine the reason for disturbances of gait and balance.
Balance and gait problems in older adults can result in an increased risk of falls and decreased ability to perform activities of daily living (ADLs). Inactivity and disuse are perhaps the most common causes of such problems because of muscle weakness, joint stiffness, and pain with activity. The fear of falling can also be a factor which leads the individual to become less active, perpetuating the likelihood of further episodes due to the accelerated motor weakness and joint stiffness.
The balance and gait problems caused by various neurological and musculoskeletal conditions can be treated with physical therapy to strengthen muscles, increase joint mobility and/or stability, reduce pain, and train the nervous system to improve the reflexes and cortical patterning related to control of gait and balance