ATAXIA GAIT DISTURBANCES

PRESENTED BY :-

PRADIP CHOUDHARY
 The patient has poor sensation or lacks muscles
coordination, there is a tendency toward poor balance and
broad base.

 The gait is irregular, jerky , and weaving

 It is also drunken gait

 DEFFINATION

 Usually a symptom not a diagnosis.

 Ataxia – failure to produce smooth intentional
movements
 Gait disorders – deviation from the normal gait.

 Cerebellar lesions are not the most common cause of

these problems.
 Pathophysiology
 Systemic
 Intoxicants
 Alcohol
 Sedatives – hypnotics
 Anti-seizure meds
 Heavy metals
 Nervous System
 Cerebellum
 Bleed, infarct, degeneration, abscess
 Cortex
 Frontal tumor, bleed, trauma, hydrocephalus
 Subcortical
 Thalamic bleed / infarct
 Parkinson’s
 Spinal Cord
 Cervical spondylosis
 Posterior column disorders
 Pathophysiology
 Motor (cereballar) ataxia
That Is due to dysfunction of the cerebellum. The
cerebellum is responsible for integrating a significant
amount of neural information that is used to
coordinate smoothly ongoing movement and to
participate in motor planning .
Cerebellar cause some basic neurological problems:-
a) Floppiness
b) Lack of co-ordination
c) Impaired ability to control distance, power, and
speed arm, leg, or eye movement.
d) An ability to perform rapid ,alternating movement
 Sensory ataxia
The term sensory ataxia is employed to indicate
ataxia due to loss of proprioception, the loss of
sensitivity to the position of joint and body part. (cause
by dysfunction of dorsal columns of spinal card )

 May be partially compensated by conscious visual

sensory input
 Clinical Examination
 Gait testing
 Normal walk
 Walk on heels
 Walk on toes
 Tandem gait
 Posture
 Cerebellar testing
 Rapid movements
 Dyssynergia
Breakdown of movements into parts
 Dysdiadochokinesia
 Clumsy (alternative movt.) movements
 Dysmetria
 Inaccurate movements
 Romberg
 Primarily test of sensation
 Eyes closed and ataxia
 Sensory ataxia or peripheral neuropathy
 Ataxic but no change with eyes closed
 Motor ataxia possible at cerebellum

 Other
 Neurosyphilis (tabes dorsalis)
 Sensory ataxia
 Slow, wide gait and stares at ground for visual cues
 Cannot walk in dark
 Other
 Nystagmus
 Suggests intercranial problem not peripheral or
spinal cord
 Ataxic gait types
 Motor ataxic or cebellar
 Wide based
 Irregular, unsteady
 Sensory ataxia
 Abrupt movement
 Slapping impact of feet
 Apraxic
 Difficult initiating step
 Equine (high stepping)
 Foot drop from peroneal weakness
 Requires high step to clear foot
 Festinating
 Narrow based
 Miniature shuffling steps
 Parkinson’s
 Ataxic gait types
 Helicopod
 Leg swings out
 Mild hemiparesis
 Unilateral proximal leg weakness
 Waddling
 Bilateral proximal leg weakness
 Functional
 All pathways working properly but patient unable to walk
normally
 Usually conversion disorder
 Wild gaits
 Dramatic form called “astasia-abasia”
 Treatment
 The most commonly used physical therapy intervention for
ataxia are :-
 Frenkel exercises,
 PNF
 Balance training
The current research suggest that, if a person is to walk with or
five without a mobility aid, include the exercise program are:-
1. static balance
2. Dynamic balance
3. Trunk-limb coordination
4. Stairs and
5. contracture


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