Unsteady gait in the elderly

Doctors usually quickly recognize that the person is not ill with anything dangerous. They then choose an appropriate method to treat the problem.

Doctors treat the wobbly gait

The symptom of wobbly gait can be a result of various diseases. If this is your first time experiencing this symptom, you should make an appointment with your GP who will refer you to an appropriate specialist.

Which doctors treat the wobbly gait

Possible diseases for the symptom of wobbly gait

• Multisystem atrophy
• Neuroleptic malignant syndrome
• Valgus deformity in children
• Parkinson's disease
• Striatonigral degeneration
• Drug-induced tremor
• Dementia in Parkinson's disease
• Systemic atrophy affecting the central nervous system

A shuffling gait is a sign of possible serious health problems, see your doctor!

All doctors who treat shuffling gait 752

Select appointments online Metro stations: Yugo-Zapadnaya Prospect Vernadskogo Prospect Vernadskogo

Select an appointment online Metro stations: Yugo-Zapadnaya Prospect Vernadskogo Prospect Vernadskogo

Recommendations before visiting the neurologist

The neurologist specializes in the treatment of diseases of the nervous system. Preparing for a consultation with a neurologist includes gathering information about your condition. The doctor must show you the results of all the examinations you have done, as well as the conclusions of the specialists. If the patient is taking any medication at the time of the examination, he should also be informed about this. To increase objectivity, avoid alcohol and smoking the night before your appointment. These can affect the neurological condition and lead to overdiagnosis.

Diagnosis of shuffling gait

Your doctor will tell you what diagnosis you need to undergo. He or she may recommend that you:

• X-ray of the foot or hand
• Ultrasound examination of the joints
• MRI of the brain
• MRI (Magnetic Resonance Imaging)
• Functional diagnostics Electroencephalography (EEG)
• Computed tomography of the brain
• Functional diagnostics Electroencephalography (EEG)
• Functional diagnostics Electroencephalography (EEG)
• Cerebral MRI
• MRI brain
• Functional diagnostics Electroneuromyography (ENMG)
• Computed tomography (CT)
• Ultrasound examination of the blood vessels in the neck
• Functional diagnostics Electroencephalography (EEG)
• MRI brain
• Duplex scan of the cerebral vessels
• Functional diagnostics Electroencephalography (EEG)
• Functional diagnostics reoencephalography (EEG)
• Computed tomography of the brain
• Ultrasound examination of the cerebral vessels
• Computed tomography of the brain
• Brain ultrasound
• PET CT
• PET CT
• MRI (Magnetic Resonance Imaging)
• MRI (Magnetic Resonance Imaging)
• MRI brain
• Functional diagnostics Reoencephalography (REG)
• Brain MRI.

Meniere's disease

The basis of Menière's disease is a dilation of the endolymphatic system of the inner ear, which provokes degenerative processes on the receptor cells of the labyrinth. The main symptom of the disease is vertigo, which can occur for several hours a day and is accompanied by progressive hearing loss. It is a chronic disease and treatment is always selected individually. Medication is prescribed, a low-salt diet and bed rest are recommended during an attack. To relieve anxiety, the doctor may prescribe sedatives that have a sedative effect. These medications should be taken between attacks, but only on the advice of a specialist.

If the disease progresses, a labyrinthectomy may be performed, in which the vestibular system of the inner ear is surgically disrupted. After this procedure, the patient must undergo a convalescence period, for which special gymnastics is important.

Dizziness in acute peripheral vestibulopathy

Vestibular neuronitis is a condition characterized by sudden dizziness. Symptoms also include nausea and vomiting without obvious hearing impairment. Unfortunately, the exact cause of the onset and progression of the disease is currently unknown, although a viral infection that selectively affects the vestibular nerves is suspected to be the trigger.

The dizziness can vary in intensity and duration, but is usually short-lived and manageable to a certain extent. The symptoms can worsen with a change in posture. However, if you stand still and try to focus your gaze on a single object, the condition can improve significantly.

Inflammation of the vestibular nerve is treated with symptomatic medications to relieve dizziness. Vestibular exercises are recommended during recovery. All drugs are selected strictly individually, taking into account the patient's age and the presence of chronic concomitant diseases in the anamnesis.

What can you do to prevent bending over?

1. Change your posture more often while working - at least once every half hour. Stand up, straighten up, stretch slightly and try to bend backwards slightly. Everything slowly and carefully.

2 – Stretch your trunk flexors in doors. PI – Stand in a doorway, extend your arms to your sides, then bend your elbows at a right angle. Place your palms and forearms against the door frame. Gently push your body forward and feel your chest muscles stretch. Return to the IP and repeat the exercise 10-15 times.

I strongly advise against going to the gym to 'train your back'. The spine can be in a double vise: if you don't eliminate the anterior muscular vise, you risk adding a posterior vise. This often leads to a herniated disc. These can of course also be treated, in most cases without medication or surgery. However, it is better to avoid additional problems.

Slow walk…

Gait can change with age. It often resembles a 'duck walk': the person walks from one side to the other. The cause lies in several muscles that are responsible for the function of the hip joints. The joint itself is usually healthy (although the diagnosis of coxarthrosis is often made based on pain symptoms). It is simply tense due to the problematic muscles and must be protected immediately from possible destruction. The aim is to identify the trigger points that have arisen (they are the cause of muscle relaxation and pain symptoms), eliminate them and, at the same time, stretch the shortened muscles to a physiological level (the use of medication is highly undesirable).

The gait changes before your eyes with this approach. The limp usually disappears within a few weeks. The freed joint is not in danger of being destroyed.

The following exercise will help you get by without professional help: IP lies on his back, legs stretched. Bend one leg at the knee joint. Grasp the bent knee with both hands (if it hurts – hold them under the knee). Pull the knee toward the opposite shoulder, do not hold your breath for 45 seconds. Do not raise your head or shoulders. Repeat this 5 times with each leg.

Gait disorder and heredity

Genetic abnormalities underlie some of the disorders that cause dysbasia and abasia. For example, gait disorders are associated with inherited nervous system disorders such as Duchenne muscular dystrophy:

• Duchenne muscular dystrophy;
• Parkinson's disease;
• hepatocerebral dystrophy;
• torsional dystonia;
• Friedreich's familial ataxia;
• Pierre-Marie ataxia of the cerebellum;
• Charcot-Marie-Tooth neural atrophy;
• Familial spastic Strumpel's paralysis;
• Werdnig-Hoffmann spinal amyotrophy;
• Progressive Erb-Roth muscular dystrophy;
• Rossolimo-Steinert-Kurszmann dystrophic myotonia;
• Kugelberg-Wehlander's spinal juvenile pseudomyopathic muscular atrophy.

Hereditary diseases manifested by gait disorders can be diagnosed using modern molecular genetic techniques: high-throughput sequencing (panel for neurodegenerative diseases), CMA, PCR (search for trinucleotide repeat expansions).

Patients with detected genetic abnormalities should be consulted by a neurologist and a geneticist.

The latest molecular genetic tests are available at the Genomed Center for Medical Genetics.

Prevention of gait disorders

A high level of physical activity helps older people maintain their mobility, even if they are already ill. Regular walking or an active lifestyle is key to maintaining normal gait. The detrimental effects of lack of exercise should not be underestimated. Walking regularly for 30 minutes a day is the best physical activity for maintaining mobility; However, walking does not lead to greater strength in weakened patients. Walking with climbing to higher ground can help maintain leg strength. Using a cane or adjustable canes can provide security for older people.

Gait impairment does not always require treatment or correction. An abnormally slow gait can help older people walk safely without assistance. However, a doctor may suggest treatment for gait disorders to improve quality of life. Treatment includes exercise, balance training and the use of assistive devices.

Strength training

Vulnerable older people with mobility problems can improve their condition through an exercise program. Walking or strength (resistance) exercises can relieve knee pain and improve gait in patients with osteoarthritis. Osteoarthritis (OA) is a chronic disease that causes damage to the cartilage and surrounding tissues. The disease is characterized by pain, stiffness and loss of function. It occurs very often with increasing age. Read more . Resistance exercises can increase strength, especially in frail people with a slow gait. This typically requires two or three sessions per week until target strength is achieved. Proper technique when exercising is important to reduce pain or avoid injury. To strengthen all major muscle groups involved in walking, a combination of leg presses (or alternatively, lifting from a chair in a weighted vest or with weight attached to the body), pull-ups, stair climbing, and knee lunges may be recommended.

Nordic walking is a walking exercise that involves the entire body and uses length-adjustable trekking poles. Compared to traditional walking, Nordic walking uses the arm and shoulder muscles and requires greater pelvic rotation, increasing stride length and walking speed. At the beginning of a Nordic walking program, inexperienced people must be supervised and trained in the safe use of trekking poles.

signs

There are several signs that suggest a gait disorder.
If you experience any of these symptoms, you should see your doctor and get checked out:

• Deviation to the side when walking;
• Dizziness;
• nausea and vomiting;
• tinnitus;
• instability when walking;
• Excessively large steps and swaying movements;
• difficulty keeping still;
• loss of coordination when closing eyes;
• difficulty initiating movement;
• Difficulty changing the speed of locomotion;
• Frequent falls;
• inability to stop when requested;
• uncertainty in movement;
• Difficulty walking on uneven terrain and overcoming obstacles.

The symptoms of the disease are related to its cause.

etiology

The problem arises from damage to the balance organs, the central nervous system (CNS) or from an asynchronous contraction of muscle groups. This is due to the presence of disease in one of the mentioned locations.

The symptoms of gait disorder are characteristic of:

• stroke in the pons or cerebellum;
• tumors in the brain or spinal cord;
• Traumatic brain injury;
• genetic abnormalities;
• neurodegenerative diseases such as multiple sclerosis;
• intoxication with alcohol, chemicals or drugs;
• cerebral palsy in children;
• Meniere's disease;
• endocrine disorders;
• Circulatory problems in the inner ear;
• tumor of the auditory nerve;
• B12 avitaminosis;
• hydrocephalus;
• Parkinson's disease;
• cerebral vascular anomalies.

The treatment of gait and balance disorders depends on the etiology of the disease and the age of the patient.

risk group.

After the age of 50, the risk of osteoporosis increases by 40 % because metabolism changes with age, signs of aging occur and bone strength decreases due to the body's loss of calcium. Calcium accounts for only 22 % of bone tissue, bones are mainly composed of collagen and water: collagen is responsible for the calcium content of bone tissue and contributes to its elasticity, while water is essential for all our body systems, including bone tissue. Zinc, boron, copper, magnesium and manganese also contribute to bone formation.

Collagen structures are also responsible for the elasticity of connective tissue: tendons, joints, blood vessel walls. They are involved in the functioning of the heart and blood vessels, strengthen the capillary system and contribute to proper digestion and the functioning of the digestive tract.

Age-related changes.

Adults are more susceptible to atherosclerosis, ischemia, angina and other heart diseases, which can eventually lead to heart attacks and strokes, because they lose too much silicon, which is twice as much in the young body. When silicon is lost, the elasticity of the vessels decreases because it is replaced by calcium on the vessel walls.

Once the concentration of calcium in the blood drops, signals are sent to the brain, which signals the parathyroid gland to make up for the calcium deficit, and the gland begins to secrete a hormone to move calcium from the bones into the bloodstream. The brain then commands the parathyroid glands to produce the hormone again to lower the calcium concentration in the blood, so that the calcium flows back to the bone structures, ligaments and joints, but cannot reach its place, depositing nearby and giving the patient in Form of thickenings and lumps appear.

If you suffer from such pathologies, as well as joint arthrosis or even joint deformities, you should definitely consult a specialist at the Natali-Med center to solve the problem or alleviate the symptoms.

prevention

When DPPH is diagnosed, the prognosis is favorable. The disease can usually be managed without lengthy treatment. It can also be treated on an outpatient basis. Some patients also receive symptomatic treatment.

Regular prophylaxis is recommended to prevent recurring attacks. If relapses do occur, they are easy to treat. For this purpose, a series of Brandt-Daroff exercises are used, which the neurologist describes in detail.

Simple balance exercises are also important and will help get rid of the seizures after a few cycles.

A therapeutic exercise instructor can teach you techniques for performing the movements. It is important that each element is carried out correctly.

Treatment

When men and women complain of mild dizziness while walking on the street or after a sudden movement, treatment is usually simple, but if the person staggers and stumbles systematically, the cause may be more serious. Treatment may then not be so easy.

Depending on the underlying cause, the doctor prescribes complex treatment [5].

The goal of treatment is not only to eliminate the symptoms, but also to treat the problem:

• Physiotherapeutic treatments: laser therapy, extreme radiofrequency, TMS (transcranial magnetic stimulation). To relieve symptoms and maintain health while the condition subsides.

• Administration of medication. When prescribing a course of treatment, the doctor combines medications that relieve symptoms and act on the cause of the problem. Sometimes drug therapy is only possible in the hospital, as some medications are administered via an infusion.

• Surgery, a surgical procedure. If the problem can be solved with medication, doctors try to avoid direct intervention in the body. However, in some cases this is the only way to save the patient's health and life.

Once the doctor has identified the symptoms of dizziness and unsteady gait, he or she can make further recommendations.

If external factors are the cause of the attacks, the doctor will prescribe preventive measures.

Sources

1. ^ Karatas, Mehmet. 'Central dizziness and lightheadedness: epidemiology, differential diagnosis and common causes'. Neurologist. 14,6 (2008): 355-64.
2. ^ Huppert, Doreen, and Thomas Brandt. 'Vertigo and vertigo syndromes in historical review'. Journal of Neurology 265, Suppl 1 (2018): 127-133.
3. ^ Gurley, Kiersten L, and Jonathan A Edlow. 'Acute dizziness.' Seminars in Neurology. 39,1 (2019): 27-40.
4. ^ Post, Robert E, and Lori M Dickerson. 'Dizziness: a diagnostic approach'. American Family Physician. 82,4 (2010): 361-8, 369.
5. ^ Spiegel, Rainer et al. 'Treatment of vertigo: a multidisciplinary update'. Swiss Medical Weekly 147 w14566. 27 Dec. 2017.

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