Balance and Difficulty walking
There are many different disorders and conditions that can contribute to difficulty with walking. Walking requires an incredibly complex interaction between the nervous system, muscles and posture of the body. Without these components, your ability to walk is compromised.
Many people do not realize how badly compromised their balance is or their limitations with walking, until they are quite degraded. It is often the fall, trip or loss of balance that is the wake up call to poor balance. In addition, the loss of being able to walk distances is a clear indicator that the balance and walking mechanisms are disrupted. Walking not only requires good balance, but the ability to know where your joints are in space (proprioception), and the ability to know how your joints are moving (kinesthesia), as well as good range of motion and strength.
As we age, with declining activity, or after an injury, walking and balancing can become difficult. With previous injuries, pain or neurological disorders, our walking pattern can also change. When walking patterns change, abnormal stresses and strains with everyday activities can be transmitted to areas it shouldn’t. For example, if you have knee pain and you begin to limp, the opposite hip and your spine now have to take double the weight. This can lead to pain and dysfunction in those areas. The good news is that if you have difficulty walking, you can be helped. Physical therapists are the experts uniquely trained to do so.
Parkinson’s Disease is a progressive disease that affects the central nervous system and the ability to coordinate movement in the body. Since Parkinson’s Disease affects many areas of the brain, symptoms can vary in individuals and progression can be either mild, moderate or aggressive. Parkinson’s Disease typically affects one’s ability to walk with slower movements (bradykinesia) and difficulty with starting or stopping walking. In addition, movements tend to become slower along with tremors that may occur in the hands. Muscles can become quite rigid, leading to loss of motion and poor posture. A dangerous symptom is called retropulsion, where the tendency of an individual is to fall backwards with little to no ability to protect oneself.
ALS (Lou Gehrig’s Disease)
Amyotrophic Lateral Sclerosis (ALS) is a progressive neurological disease that typically begins in the hands, feet and extremities, then progresses centrally. People may first discover that they have difficulty walking, tripping or poor balance. In addition, people may notice that they have weakness in their hands or legs, along with occasional muscle cramps.
As the disease progresses, it affects walking, use of the arms, speaking, swallowing and breathing muscles. While there is no cure for ALS, maintaining independence and function as long as possible is the goal of the rehabilitation team. Safety with walking and adaptation of assistive devices is critical to prevent secondary complications such as fractures from falls.
Spinal Cord Injuries
Depending on where a spinal cord injury occurs, it affects various areas of the body. A spinal cord injury may be complete, causing full paralysis of the muscles below that level, or partial causing various symptoms or partial paralysis. With today’s technologies in medicine and rehabilitation, more and more spinal cord injury patients are experiencing gains like never before. The management of a spinal cord injury is a progressive affair from the hospital, through inpatient care and finally outpatient care.
Since the nerves are one of the slowest regenerating cells in the body, improvements can be made months, even years after the initial injury. Furthermore, areas that are paralyzed have a tendency to lose range of motion, atrophy and can affect posture. Maintaining posture and upper body strength is critical for spinal cord injury patients to assist with breathing and digestion. In addition, the ability to shift and move one’s body throughout the day is important to prevent pressure sores.
Multiple Sclerosis (MS) is neurological disease that causes the body’s immune system to abnormally attack the covering of the nerve cells, called myelin. This causes scarring and decreases the nerve’s ability to transmit signals properly. The progression of MS is based on 4 different types of aggressiveness. Multiple sclerosis is categorized by bouts of activity, with periods of minimal to no activity, depending on the different type of MS you may be suffering from. Symptoms can vary person to person dramatically as different parts of the brain, spinal cord or peripheral nerves are affected, making no two cases alike.
Common symptoms of MS are fatigue, numbness or tingling in the face, body or extremities, weakness, dizziness or vertigo, pain, walking difficulties, loss of balance, bladder and bowel problems and emotional / cognitive changes.
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