Research found that the walking gait of a horse is actually fairly similar to that of a person. This sparked an idea that strength building for increased mobility could be worked on through the practice of horseback-riding therapy. Knowing the difference between the common types of gait disorders may assist in the understanding the benefits equine therapy provides.
Hemiplegic gait means that a patient stands with unilateral weakness—one side of the body is weaker than the other and can affect the side, an arm when flexed, adducted, or rotated internally. It can appear in the leg on the same side in extension with issues in the foot and toes, such as plantar flexion (movement where the top of the foot points away from the leg). This is associated with standing on tip toes or simply pointing them. Hemiplegic gait can limit abilities to control these limbs.
Typically, with this type of gait, a patient will hold the arm to one side and drag the affected leg in a semicircle referred to as “circumduction” because of the weak distal muscles. This is most commonly seen following a stroke. If the effects are minor, mild paralysis of the one side may be the only abnormalities.
Spastic Diplegic Gait
Diplegic gait is when a patient has spasticity (stiff or tightened muscles) on both sides of their body. The lower extremities are often more affected than the upper ones. A person suffering from this type of gait is often characterized as dragging both legs and scraping their toes. It can be seen in bilateral periventricular lesions (located between the cortex and ventricles on both sides of the brain). Diplegic gait can also be see in those with cerebral palsy.
Other characteristics of this condition are extreme hip adductor tightness which can lead to a term called “scissor gait” where the legs cross the midline making the person appear as though they are crouching. Often in those with spastic cerebral palsy, this flexing of the legs, hips, and pelvis makes steps small and slow.
Neuropathic gait is also referred to as steppage gait or equine gait. This is weakness in the foot and can be indicated by a foot drop within patients. It’s caused by an attempt to lift the leg high enough while walking to avoid foot dragging. If this condition is unilateral (affecting one side), then it can be caused by peroneal nerve palsy and L5 radiculopathy. If it’s bilateral (affecting both sides), then it could be caused by amyotrophic lateral sclerosis, Charcot-Marie-Tooth disease, or another peripheral neuropathy associated with uncontrolled diabetes.
Myopathic gait, also known as waddling gait, is caused by weakness in the muscles in the pelvic girdle. That is a bowl-shaped collection of bones and muscles that connects the torso to the hips and legs. A hip may dip on one side while walking. With bilateral weakness, the dropping of the pelvis will occur on both sides while walking, which causes patients to look as if they’re waddling. This type of gait occurs in a patient with myopathies such as muscular dystrophy.
Choreiform gait is also known as Hyperkinetic gait and is seen in disorders such as Sydenham’s Chorea or Huntington’s Disease. It may be present in other forms of chorea, athetosis, or dystonia as well. Movements of the patient will appear irregular or jerky. The individual experiencing this type of gait will have involuntary movements in all of their extremities. Walking can emphasize this baseline movement disorder.
Ataxic (Cerebellar) Gait
Ataxic or Cerebellar gait is most common in those with a cerebellar disorder where the cerebellum becomes damaged or inflamed. This is because the cerebellum is the part of the brain that controls gait and coordination of muscles. This can be caused by congenital malformations, acquired damage or conditions, or hereditary ataxias.
This impaired muscle coordination may appear as clumsiness or staggering. Swaying or nodding of the head or body back and forth while standing may be an indication of this; it’s known as titubation. This type of gait hinders the patient from being able to walk in a straight line or from heel to toe. It resembles the gait of someone who is intoxicated by alcohol.
Parkinsonian gait occurs with patients who have rigidity or bradykinesia (slowness of movements). Bradykinesia and tremors are experienced by people with Parkinson’s Disease. Indications of this gait type are a head and neck stooped forward and flexion (consistently bent) at the knees. Typically, the upper part of the body is also in flexion with extended fingers.
The patient’s walk is slow with small steps that they may have difficulty initiating. An additional effect is festination which is an involuntary inclination to accelerate steps. Though it’s most commonly seen in people suffering from Parkinson’s, it can present as a side effect from certain medications.
Sensory gait, or Sensory Ataxic gait, is loss of proprioceptive input (the body’s ability to receive input through receptors.) This means that the patient is experiencing difficulty feeling the ground when their feet touch it. Often people who experience this type of gait will slam their feet on the ground in an effort to sense when and where their feet landed. This can be exacerbated in the dark when someone who experiences this cannot see their feet. This condition may also be referred to as a “stomping gait” as patients lift their legs higher than usual to hit the ground harder.
This gait is common in people with disorders of the dorsal columns or in diseases that affect their peripheral nerves. In its severest form, this gait can cause an ataxia that will resemble the Ataxic gait.
We at Chariot Innovations understand there are several common types of gait disorders. Even with known effects, each gait disorder affects an individual in its own way. Difficulty with mobility and with a walking gait can be debilitating, frustrating, and exhausting. The MiraColt is designed to target thousands of muscles simultaneously to provide support, comfort, and help with strength and flexibility. There are so many benefits that come with equine riding therapy. Being able to use it from the comfort of a controlled environment can help with consistency and training during many types of therapy. Contact us today to learn more about the MiraColt and hippotherapy simulators.