Tuesday, 17 April 2012

Spastic Gait

I realised that I've been blogging for a while and haven't really touched upon the primary outcome of FSP/HSP - the spastic gait. This is also identified on some FSP sites as a scissor gait.

There are a number of references which give descriptions of a spastic gait - here's part of one I like:

When a person has a spastic gait, his legs are typically weak and abnormally stiff. As he walks, he holds his legs closer together than normal, drags his feet or toes, and lacks the typical flexibility in his ankles and knees. When a person has a spastic gait, his legs, toes, and feet are stiffer than normal. He typically does not flex his muscles and bend his legs as he walks. Instead, long-term muscle contractions usually  cause him to drag one foot or his toes when he walks. Sometimes medications may also be used to treat this gait problem. For example, medicines may be used to reduce muscle contraction, but the effects of many medications are still being studied. (http://www.wisegeek.com/what-is-a-spastic-gait.htm)

Here is a description of scissor gait http://www.gpnotebook.co.uk/simplepage.cfm?ID=818937856Scissor gait is the term used to describe the manner of walking that is seen in patients with spastic paraplegia, the features are:

  • rigidity and excessive adduction of the leg in swing
  • plantar flexion of the ankle
  • flexion at the knee
  • adduction and internal rotation at the hip
  • contractures of all spastic muscles

The individual is thus forced to walk up on tip-toe, the other contractures resulting in the knees rubbing together and crossing in a manner analogous to scissors.

Of course, the shortest definitions are often the best: http://medical-dictionary.thefreedictionary.com/Scissors+gait:
scissors gait a crossing of the legs while advancing with slow, small steps.
spastic gait a walk in which the legs are held together and move in a stiff manner, the toes seeming to drag and catch. A slow, shuffling gait in which the patient appears to be wading in water. Knee and hip movements are restricted.

What I'm looking for is the sequence. It would appear to start like this: Initial symptoms are typically difficulty with balance, stubbing the toe or stumbling. (symptoms: http://en.wikipedia.org/wiki/Hereditary_spastic_paraplegia) but there doesnt seem to be much around which describe the next steps. Perhaps this is something I'll have to note myself in my symptoms updates.

I also found these exercises which claim to improve gait:

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