ataxic gait defination | ataxic gait symptoms | ataxic gait meaning | ataxic gait causes | ataxic gait treatment

ataxic gait defination | ataxic gait symptoms | ataxic gait meaning | ataxic gait causes |ataxic gait treatment

Definition:

A loss of normal capacity to modulate fine motor movement, the patient complaint of unsteady and uncoordinated movement and lack of balance during movement it is due to cerebellar dysfunction.

The ataxic gait are of two type:

(a) Sensory gait: In ataxic gait the cerebellar are intact but the afferent fibers are     affected i.e sensory input

Sign and Symptom

-Typically the patient have lost proprioceptive and sensory input in lower limb

-They are unaware of their limb positioning

-Thus at the time of walking, they take step that are higher than necessary, while careful monitoring the ground

-Only patient with sensory ataxia slap on the floor to increase the sensory input

-And although their stance is as wide based as that of cerebellar ataxia, only sensory ataxia patients present with positive Romberg’s (swaying and falling after loss of compensatory visual input).  

(b) Cerebellar gait : This is unsteady and staggering gait towards the side of the lesion due to cerebellar lesion.

Sign and symptoms

- It is accompanied by swaying to one side or the other, so that patients often look for something to lean on – a cane, a bed rail, or even the wall.  

 -When attempting to walk tandem (heel to toe gait) it fails to maintain balance.

-Stance is also widened, but this is not enough to prevent staggering.

-Titubation while standing (fore-and-aft tremor of head and trunk) worsens considerably when patients are asked to close feet and narrow base, causing fall.

-Thus opening (or closing) the eyes neither improves nor worsens stance (negative Romberg’s)

- Hence, it differs from sensory ataxia since it is associated with other signs of cerebellar deficit, such as dysmetria , dysarthria, nystagmus, hypotonia, and intention tremor

PT management

A. provide psychological support

Give positive motivation

Gain patient confidence

Include group therapy

Explain goal and importance of exercise

B. postural correction

Use of pillows, pads to prevent abnormal posture

Use of mirror for visual feedback

Braces to correct to maintain the correct trunks

C. Sensory re-education

Use of sensory training technique like stroking, brushing and tapping

Foot splint with straps

Function stimulation

D.co-ordination and balance exercise

Non-equilibrium exercise: finger to finger exercise, finger to nose exercise, heel to shine exercise, altered pronation  /supination

Equilibrium exercise: stand with normal BOS, stand with eye open/close, stand on one leg, sit to stand, wall squatting

E. gait training

Parallel bar walking using mirror as a biofeedback

Weight shifting

Walking side way

Walking in uneven surface with support and later progress without using support

Improve heel to toe gait