Need to Know: What Is Gait?

Editor’s note: “Need to Know” is a series inspired by common forum questions and comments from readers. Have a comment or question about MS? Visit our forum.

This week’s question is inspired by the forum topic “How Do You Manage MS-Related Balance Issues?” from April 12, 2018.

What is gait?

To put it simply, it’s your walking style. Healthy people may call it their swagger. People with compromised gait may also — tongue-in-cheek — reference their own swagger.

But what does walking style have to do with multiple sclerosis (MS) and why does it matter?

When gait loses its swagger

People with MS frequently encounter problems with their walking patterns. Gait issues are among the most common mobility problems experienced by people with MS, according to the National Multiple Sclerosis Society (NMSS).

Following are the reasons why we might “lose our swagger”:

• Numbness in the feet: It can be hard to know where your feet are stepping if you can’t even feel them.
• Heaviness in the legs and feet: It takes a lot of effort to lift leaden legs and move heavy feet when you’re feeling fatigued.
• Tight muscles and spasticity: Rigid, tight, and spasming muscles affect movement of the legs and feet and can interfere with a smooth walking pattern.
• Foot drop and other involuntary gait adjustments: Foot drop is when you drag your toes because of weakness in the foot and leg muscles. Other compensatory gait patterns involving weak muscles due to MS include hip hike, trunk lean, and vaulting. Some people with MS experience one-sided leg weakness.
• Balance issues: Sometimes your legs work just fine, but you can experience severe neurological-related balance problems which lead to the appearance of being “drunk” or uncoordinated while walking.

Why does managing one’s gait matter?

Problems with gait can lead to falls, which can cause injuries. Up to 70 percent of people with MS experience at least one fall over a period of two to six months, according to research highlighted at the 5th International Symposium on Gait and Balance in MS — Fall Detection and Prevention in 2015. Nearly one-third reported multiple falls and injuries.

Bad falls in MS aren’t caused by engaging in strenuous activities or athletic efforts. The NMSS reports that most falls occur close to home while carrying out daily tasks such as showering, walking outside among other people, and cooking.

How to manage risks of falls?

If you experience balance and coordination issues, talk to your neurologist about your options. Falls can be dangerous for people with MS. Even when your legs are strong, balance problems can lead to catastrophe.

If your legs and feet are affected by your MS disease activity, you have options for improving your gait.

The following approaches can help to prevent falls and may even correct gait in some of those with MS.

• Use of assistive devices: These include canes, braces, and walkers. Even if you only need them temporarily, they can be a godsend.
• Proper training in the use of these devices: Review your technique with your neurologist as improper use of canes and walkers can lead to pain and postural problems as well as falls.
• Fall-proof your home: Check your floors for hazards and add handrails, where practical.
• Fall-proof your clothes: Choose supportive footwear with good traction and avoid clothing that drapes to prevent tripping.
• Distribute your weight evenly when walking: Avoid carrying heavy bags and backpacks that can upset your balance and interfere with your stride.
• Stretching: Daily actions to loosen tight, spastic muscles can go a long way toward improving your gait.
• Strengthening: Lightweight training can help to maintain muscle tone and improve foot and muscle weakness.
• Muscle relaxants for spasticity: The most common medications used to treat muscular rigidity and spasms are baclofen and tizanidine.

Do you struggle with your balance when walking? Is your gait compromised? What have you done to improve your gait? Post your replies in the comments below or at the original “How Do You Manage MS-Related Balance Issues?” forum entry.

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