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
