Gait/Balance Disorders Program

Introduction:

Maintaining safe gait & balance is key to function, independence and quality of life.

Difficulty with walking and balance are quite common and can significantly impact quality of life and independence, as well as general health.  These problems are most often assumed to be related to bone and joint issues, such as arthritis or spine difficulties, or perhaps just “slowing down with age.”  However, the mechanics and physiology of gait are quite complex and the nervous system is often at fault creating instability and threatening one’s independence.  If identified and treated, serious threats or falls may be avoided.  Specific treatment is typically quite successful in stabilizing or improving many gait difficulties.

Causes of Instability and Difficulty Walking:

Virtually any part of the nervous system, if troubled, can contribute to instability and difficulty with walking.  Examples include:

1. Brain disorders are often subtle and progress slowly, with the affected individual thinking their deterioration may just be “old age.” However, neurodegenerative disorders such as Parkinson’s disease, Alzheimer’s disease and Multiple Sclerosis may first be noticed as trouble walking. In addition, stroke, tumors, blood clots or other brain disorders can affect stability and gait.

2. The cerebellum is the portion of the brain which controls coordination.  Any disorder adversely impacting its function will produce an unsteady, or ataxic, gait.

3. The vestibular apparatus is a component of the inner ear that senses gravity and motion. A minor vestibular disorder, is often experienced as a sense an imbalance without accompanying symptoms. When severe difficulties are encountered, a distinct sense of spinning, or vertigo, is experienced, often accompanied by hearing loss or ringing in the ears.

4. Spinal cord disorders may emerge slowly and gradually, often escaping early detection. For example, if an individual has arthritic or disc degeneration in the cervical spine, pressure may be put upon the spinal cord creating a unique clinical picture of weakness and unsteadiness. If not treated, serious and permanent damage can occur. There are also medical conditions, such as B12 deficiency or auto-immune inflammatory injuries, which can damage the spinal cord.

5. The peripheral nerves carry messages from our skin and joint receptors to our brains and from our brains to our muscles. Nerve damage, or neuropathy, can cause difficulty with power, stamina and our sense of balance. This can occur in the absence of pain, the more typical symptom of neuropathy. Safety is a concern with these types of disorders, particularly during the winter months when snow and ice produce unsafe footing.

6. Spinal stenosis, a narrowing in the center of the lumbar spine, is a syndrome with symptoms not so much of back pain or sciatica, but instead a threatening loss of stamina and mobility severely limiting power and independence.

7. Muscle diseases can create weakness as seen in Myositis, Myopathies, or Myasthenia Gravis.

In many instances, more than one condition plays a role in limiting balance, stability and walking.  Falls, and sometimes fractures, can be a serious result of these deteriorating conditions.

Evaluation and Treatment of Gait and Balance Disorders:

At Minneapolis Clinic of Neurology, we are concerned with maximizing safety and independence.  Our physical therapists have extensive training and experience in gait and balance assessment and rehabilitation.

Gait & Balance therapy may include:

Balance Training
Vestibular Rehab
Gait Training
Falls Risk Assessment and Intervention
Coordination Training
Postural/Strength Training

Minneapolis Clinic of Neurology offers a collaborative, multidisciplinary approach to gait analysis and intervention at our Edina Office and Golden Valley Office.  We provide a unique collaboration of neurologists, physical therapists and orthotists in the analysis and diagnosis of walking and/or balance difficulties and advanced treatment planning.  Our neurologists are experts in all forms of neurological disorders possibly contributing to a gait disorder.  Our physical therapists have unique expertise in identifying and treating patients with neurological problems, including gait difficulties.  And, the orthotists we work with offer inexpensive “off-the-shelf” aides, custom bracing, as well as advanced orthotic technology. Once the team completes the analysis and diagnostic components, treatment is planned, implemented and continually reassessed for effectiveness.  Our Edina and Golden Valley offices are equipped with body-weight supported gait devices (which allow for gait and balance treatments with a portion of the patient’s body weight decreased), allowing for more advanced treatment options without the risk or fear of falling.