gait ataxia
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Etiology
- generally multifactorial in the elderly[4]
- muscle weakness
- sensory/balance deficit
- limited range of motion
- impaired central processing
- dementia
- stroke, especially deep white matter & small vessel disease[3]
- normal pressure hydrocephalus
- delirium
- drugs
- pain
- arthritis
- injury
- spasticity
Epidemiology
- common in older adults[4]
Clinical manifestations
- short steps, slow speed, difficulty turning, wide base suggest peripheral neuropathy[4]
- weakness of hip abductors manifests as Trendelenburg gait
- difficulty initiating movement, cautious gait, variable step length & stance time, difficulty moving around an object or stepping over a threshold, & difficulty maintaining a conversation while walking suggest cognitive impairment[4]
Diagnostic procedures
- electronystagmogram may be helpful for identifying involvement of the peripheral vestibular system
- nerve conduction study/electromyography may be useful for evaluating a peripheral neuropathy
Complications
- predictor of functional decline in older adults[4][5]
- inability to walk 400 meters associated with increased mortality (see Health, Aging & Body Composition Study)
Management
More general terms
More specific terms
- antalgic gait
- circumduction
- equinovarus
- festination
- foot drop
- foot slap
- freezing of gait
- genu recurvatum
- high-step gait; steppage gait
- magnetic gait (magnetic feet)
- propulsion
- psychogenic gait
- retropulsion (tendency to fall backward)
- scissoring
- Trendelenburg gait
- turn en bloc
Additional terms
References
- ↑ nlmpubs.nlm.nih.gov/hstat/ahcpr/
- ↑ Sepulveda GRECC guidelines
- ↑ 3.0 3.1 UCLA Intensive Course in Geriatric Medicine & Board Review, Marina Del Ray, CA, Sept 12-15, 2001
- ↑ 4.0 4.1 4.2 4.3 4.4 4.5 4.6 Geriatric Review Syllabus, 8th edition (GRS8) Durso SC and Sullivan GN (eds) American Geriatrics Society, 2013
Geriatric Review Syllabus, 10th edition (GRS10) Harper GM, Lyons WL, Potter JF (eds) American Geriatrics Society, 2019
Geriatric Review Syllabus, 11th edition (GRS11) Harper GM, Lyons WL, Potter JF (eds) American Geriatrics Society, 2022 - ↑ 5.0 5.1 Abellan van Kan G, Rolland Y, Andrieu S et al Gait speed at usual pace as a predictor of adverse outcomes in community-dwelling older people an International Academy on Nutrition and Aging (IANA) Task Force. J Nutr Health Aging. 2009 Dec;13(10):881-9. Review. PMID: https://www.ncbi.nlm.nih.gov/pubmed/19924348
- ↑ Studenski S, Perera S, Patel K Gait speed and survival in older adults. JAMA. 2011 Jan 5;305(1):50-8 PMID: https://www.ncbi.nlm.nih.gov/pubmed/21205966
- ↑ Nutt JG, Horak FB, Bloem BR. Milestones in gait, balance, and falling. Mov Disord. 2011 May;26(6):1166-74 PMID: https://www.ncbi.nlm.nih.gov/pubmed/21626560
- ↑ Salzman B. Gait and balance disorders in older adults. Am Fam Physician. 2010 Jul 1;82(1):61-8. PMID: https://www.ncbi.nlm.nih.gov/pubmed/20590073