Ataxia refers to an abnormal gait pattern due to lower extremity weakness, lack of lower extremity range of motion, and/or uncoordinated movements. Common ataxic gait patterns seen are slower cadence than expected for a person’s age, lateral trunk lean, hip circumduction, hip hiking, vaulting, and inadequate dorsiflexion control (“foot drop”).
Slower cadence than expected for age matched peers can be a result of lower extremity pain, generalized weakness, lower extremity AROM restrictions, or increased muscle tone. This could result in many different gait abnormalities such as shorter stance phase on involved side with a shorter swing phase on uninvolved side. To achieve safe community ambulation, gait speed should exceed 0.8 m/second.
A gait characterized by a lateral trunk lean is most often the result of hip abductor muscle weakness (compensation for gluteus medius and a Trendelenburg gait pattern) if leaning toward the affected hip or decreased hip flexion and mild hip abductor weakness if leaning toward the unaffected hip. Other causes of a gait characterized by lateral trunk lean include a painful hip, an abnormal hip joint (dysplasia, coxa vara, etc.), unequal leg length, adaptive shortening of the quadratus lumborum, or a hip flexion contracture.
Hip circumduction is described as a gait pattern in which one avoids ground contact with the leg by swinging it outward instead of forward in the sagittal plane. A gait pattern with hip circumduction can occur because secondary to a functional leg-length discrepancy (reduced flexion, reduced knee flexion, and /or lack of ankle dorsiflexion), an anatomical leg-length discrepancy, or an arthrogenic stiff hip and/or knee.
Hip hiking is described as a gait pattern in which the pelvis is lifted superiorly on the side of the swinging leg. This gait pattern can occur due to a functional leg-length discrepancy, an anatomic leg-length discrepancy, an arthrogenic stiff hip and/or knee, ipsilateral quadratus lumborum shortening, or ipsilateral hamstring weakness.
A vaulting gait pattern is described as achieving ground clearance of the swinging leg by going up onto the toes of the stance leg. A gait pattern with vaulting can occur secondary to a functional or an anatomic leg-length discrepancy.
A gait pattern with inadequate dorsiflexion control during initial foot contact (“drop foot”) can cause a steppage gait pattern to lift foot for increased ground clearance. This type of gait pattern can occur secondary to weak or paralyzed dorsiflexors, lack of lower limb proprioception, weak or functional or anatomic leg length discrepancy.
A physical therapy evaluation will identify any restrictions and weaknesses in each of the lower extremities. Together with the patient, the therapist will create a plan of care to address any deficits in order to restore gait pattern, increase ambulation endurance, and reach the patient’s personal goals.
If you or a loved one is suffering from Ataxia, please come see us for a free consultation to see how we can assist you in your recovery. To request an appointment, click here, or call directly to one of our three locations during regular business hours:
Cool Springs: 615-224-9810
Spring Hill: 931-489-2022