Gait (the process of walking) and balance are intricate movements. They rely on proper functioning from several areas of the body. These include the ears, eyes, brain, and muscles. Problems with any of these areas can lead to walking difficulties, falls, or injury if not addressed.
Walking difficulties may be temporary or long-term, depending on the cause.
Potential causes of temporary gait or balance problems include injury, trauma, inflammation, or pain. Longer-term difficulties often result from muscular neurological issues.
Problems with gait, balance, and coordination are often caused by specific conditions. These include:
- joint pain or conditions, such as arthritis
- multiple sclerosis (MS)
- Meniere's disease
- brain hemorrhage
- brain tumor
- Parkinson’s disease
- Arnold-Chiari malformation
- spinal cord compression or infarction
- Guillain Barre
- peripheral neuropathy
- cerebral palsy
- muscular dystrophy
Obesity, chronic alcohol abuse, vitamin B12 deficiency, and stroke are other causes. The condition may also be the result of vertigo, migraines, deformities, and certain medications including antihypertensives.
Gait and balance problems can be a result of pain, muscle weakness, muscle tightness or spasticity, loss of balance, or poor posture. Other causes include limited range of motion, numbness (sensory deficit), and fatigue. Muscle weakness can occur in one leg or both, and make walking difficult. Foot numbness makes it difficult to know where the feet are moving or whether they are touching the floor.
The most common symptoms of gait and balance problems include difficulty walking, trouble with balance, and unsteadiness. Patients can experience dizziness, light-headedness, vertigo, motion sickness, or double vision.
Other symptoms may occur depending on the underlying cause or condition.
A physical and neurological examination can diagnose gait or balance problems. Doctors typically also ask questions about symptoms and severity.
Performance testing can then be used to assess individual gait difficulties. Potential further tests to identify causes include hearing tests, inner ear imaging, and vision tests including watching eye movement. Magnetic resonance imaging (MRI) or a computed tomography (CT) scan can check the brain and/or blood pressure/heart rates tests. A doctor will look to find which part of the nervous system is contributing to the gait and balance problems.
Treatment for gait and balance problems depends on the cause. Treatments may include medications and physical therapy, or rehabilitation to learn to function or compensate for lack of balance. Affected patients may also learn how to prevent falls. For vertigo-caused balance issues, you may learn how to position your head to regain balance.
The prognosis of gait and balance problems is dependent on the underlying medical condition.
Falls in older adults, due to gait and balance problems, are a common cause of mortality and morbidity and can lead to injury, loss of independence, and change in lifestyle.