Balance and Gait Disorder
Gait and balance disorders are common in older adults and are a major cause of falls in this population. They are associated with increased morbidity and mortality, reduced level of function, injury, disability, loss of independence, and limited quality of life. Many underlying conditions may be vestibular, neurological, or muscular. The Timed Up and Go test is a fast and reliable diagnostic tool. People who have difficulty or demonstrate unsteadiness performing the Timed Up and Go test require further assessment.
Usually with a physical therapist, to help elucidate gait impairments and related functional limitations. Most changes in gait are related to underlying medical conditions and should not be considered an inevitable consequence of aging. Evidence on the effectiveness of interventions for gait and balance disorders is limited because of the lack of standardized outcome measures determining gait and balance abilities. However, effective options for patients with gait and balance disorders include exercise and physical therapy.
How can the physical therapist help?
Physical therapists play a vital role in helping individuals improve their gait. Your physical therapist will work with you to develop a treatment plan to help address your specific needs and goals. Your physical therapist will design an individualized program to treat your specific condition. They may begin your treatment by having you perform balance activities and exercises that will help you understand and stabilize your walking pattern. These exercises may include simple activities, such as having you stand and lift your leg in place, to more complex strategies like stepping in place and initiating contact with your heel to the ground, prior to other portions of the foot. They will employ neuromuscular reeducation techniques to activate any inactive muscle groups that may be affecting your gait pattern.
Medical conditions associated with gait and balance disorders are the following: limb pain, dyspnea, imbalance, diminished strength, limited range of motion, poor posture, decreased sensory perception, fatigue, deformity, and decreased awareness of and ability to adapt to and traverse through possibly hazardous surroundings. In addition, recent surgery or hospitalization and other acute medical illnesses may lead to gait and balance disorders. The use of multiple medications (four or more) can lead to gait disorders and an increased rate of falls.