Gait disorders (synonyms: abnormal gait; ataxic gait; ataxia; external rotation gait; dysbasia; gait abnormality; gait ataxia; gait disorder; internal rotation gait; gait disorder; paralytic gait; paretic gait; problem walking; swaying gait; spastic gait; staggering gait; toe-tapping gait; ICD-10-GM R26.-: Disorders of gait and mobility) are disorders of movement that affect walking or gait pattern.
Gait disorders can be subdivided as follows (see “Classification” below):
- Hereditary (inherited) ataxias.
- Sporadic (non-hereditary) degenerative ataxias
- Acquired ataxias
They can have neurological, orthopedic or psychogenic causes.
According to Nutt and Marsden, the following classification of gait disorders can be made:
- Changes in the lower level – the peripheral effector organs, for example, in sarcopenia (muscle weakness or muscle wasting), osteoarthritis.
- Changes of the middle level – in the central nervous system, e.g., after apoplexy (stroke).
- Higher level changes – higher level control deficits, e.g. psychogenic gait disorders (anxiety).
Gait disorders can be a symptom of many diseases (see under “Differential diagnoses”).
Frequency peak: the disease occurs predominantly in older people (> 65 years).
The prevalence (disease frequency) is up to 15% in the group of people over 65 years and about 40% in the group of people over 85 years (in Germany).
Course and prognosis: Gait disorders are an important risk factor for falls and resulting injuries. Course and prognosis depend on the underlying disease on the one hand and on how long the gait disorder has existed on the other. The prognosis is most favorable in orthopedic gait disorders. Psychogenic gait disorders are also reversible in most cases if the cause is known. Neurological gait disorders are only usually incompletely reversible.
Note: Gait disorders must be distinguished from gait insecurities: In gait unsteadiness in the elderly (> 75 years), dizziness is the most common leading symptom.
