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What is functional gait disorder?

Sandeep Dhanyamraju MD
Medically reviewed by Sandeep Dhanyamraju
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Sandeep Dhanyamraju MD
Medically reviewed by Sandeep Dhanyamraju

Functional gait disorders involve the presence of movements or positions of parts of the body due to the malfunctioning of the nervous system (not associated with organic damage to the nervous system). Various types of gait disorders are a type of functional disorders.

The most common types of functional gait disorders are:

  • Dragging gait (functional weakness). One of the most common FGDs is leg dragging, which occurs in patients with functional weakness in one leg. People with this type of gait disorder report that their foot is dragging along the ground. Often, it doesn’t look as dramatic. The foot is often turned inward or outward. Some note that their foot feels as if it is magnetized to the ground.
  • Sudden bending of the knees. This type of gait disorder is usually found in functional weakness in one or both legs. Sometimes, when both knees bend at the same time, a drop attack occurs. However, it is essential to recognize other causes of this condition, such as knee problems.
  • Small slow steps, as if on ice. This is mainly an unstable gait when a person takes small steps, almost like walking on ice. At the same time, the legs are tense, and the feet are far apart from each other. Usually, the reason for this gait is that the person has had a fall episode and is now afraid of repetition.
  • Swinging (oscillating) gait. In this type of gait disorder, the person sways from side to side, especially the upper body, and the legs correct these movements. The person seems to be about to fall, but then he holds himself back.
  • Hyperkinetic gait. Functional movement disorders can sometimes cause excessive dramatic movements in the arms, legs, or trunk, which some may experience while walking.
  • Squat gait. This is a rare form of FGD in which the person appears to squat. Often associated with fear of falling. Functional disorders of standing (astasia). With these disorders, the person has problems with standing but can walk normally. Astasia can be diagnosed if the symptoms go away when the patient is distracted (playing games on the phone or guessing the numbers written on his back).

How are functional gait disorders diagnosed?

A neurologist usually diagnoses FGD. Diagnosis is not an easy task and requires detailed knowledge of all neurology diseases with movement disorders, many of which are unusual and even eccentric. Even a neurologist must be especially careful when diagnosing FGD. The error rate in the diagnosis of FGD in neurology is significantly higher than in other gait disorders.

Features to help diagnose functional gait disorders:

  • Identifying positive signs of functional tremor or functional weakness in the limbs
  • Frequent side steps (retreats) and other uneconomical gaits (require more energy than normal)
  • Better gait when walking backward
  • Improving gait when changing speed and rhythm of movement
  • Improving gait when listening to music
  • Balance problems while standing are reduced when the person is distracted by other tasks, such as guessing the numbers written on their back and playing on their mobile phones.

Psychotherapy is an essential component in treating functional gait disorders (the specialist must be well-versed in functional disorders). Some therapies may seem a little unusual and strange, but they are all aimed at helping the brain return to its normal automatism of movements. Correct diagnosis is essential to the success of FGD treatment.

If you doubt your diagnosis, you will be reluctant to use the methods listed below.

  • Try humming a song (you can do it in your head) as you walk. Is it easier for you to walk after that?
  • Try to walk backward. Walking like this is a different program in your head, and you will be surprised how much easier it is than walking.
  • Run. Sometimes, light jogging allows you to move more easily. This phenomenon is observed in patients with stuttering who manage to sing normally.
  • If you are trying to start walking and cannot, try to stand up straight and shift your weight from one leg to the other for a few minutes.

Why is there an imbalance or gait disorder?

There can be many causes of imbalance and gait disturbances, as they can develop from many different underlying conditions. When it comes to balancing disorders, many are associated with problems in the vestibular system, which is a delicate collection of fluid-filled chambers and sensory nerves located in the inner ear and thousands of nerve receptors in joints throughout the body. The vestibular system is responsible for your sense of position, also known as proprioception.

Some common vestibular conditions leading to gait disorders include:

  • Injury or discomfort. Even if your brain and nervous system are working in harmony, sudden injury, illness, or another ailment that causes muscle weakness can upset your balance and make it difficult to maintain balance.
  • Neurological problems. This can include Parkinson’s disease, brain injury, or stroke. Anything that affects your neurological system can also affect your balance.
  • Benign paroxysmal positional vertigo. It happens when calcium debris breaks down in the inner ear, causing balance problems.

What diseases cause functional gait disorders?

Why is there an imbalance or gait disorder

The main coordinators of normal gait and balance are the person’s eyes and inner ear. Accordingly, poor eyesight, infectious diseases of these organs, and neurology often disturb the balance and, as a result, change its gait. The use of alcoholic beverages, narcotic drugs, uncontrolled intake of medications, including sedatives, also takes note of the last place among the causes of disturbed gait.

Any pathology in the nervous and muscular system of a person can lead to gait disorders. First of all, we are talking about the infringement of intervertebral discs.

If we talk about more severe causes of gait disorders, such diseases as multiple sclerosis, amyotrophic lateral sclerosis, muscular dystrophy, and Parkinson’s disease come to the fore.

Several different diseases are associated with gait disturbances.

  • Spastic hemiparesis causes a hemiplegic gait. In such a violation, the patient has a change in the position of the upper and lower extremities relative to the body. The elbow, wrist, fingers are bent, the shoulder is turned inward, the leg in the joints – knee, hip, and ankle – is unbent. In milder cases, the arm is in a normal position, but its ability to move when walking is still limited.
  • Paraparetic gait can be observed in people with varying degrees of spinal cord injury and cerebral palsy.
  • Limited flexion of the foot from the dorsum causes the gait with the very sonorous name of the cock. Due to the complete or partial dangling of the foot during the step, the toes touch the surface, and the person should raise the leg as high as possible to avoid this.
  • Weakness in the proximal muscles of the leg, which occurs with myopathies and spinal amyotrophy, causes a person to walk waddling from side to side. This gait disorder is called the duck gait.
  • The following signs can recognize parkinsonian (akinetic-reticular) gait: the patient’s back is bent, their legs are bent, and their arms are bent while resting tremors can occur. The patient begins to move by leaning forward. While walking, a person makes mincing steps that make a shuffling sound.
  • Apraxic gait can usually be observed in patients with bilateral frontal lobe lesions. Symptoms of gait disturbances, in this case, are very similar to parkinsonian, but there are several differences. The patient is easily given some of the movements that make up walking while they can lie or stand. But as soon as one has to start walking, a person is not able to do it. Finally, having moved forward, the patient stops again. Such attempts to move are repeated several times.
  • Choreoathetosis gait is characterized by a violation of the walking process by abrupt, as if through force, movements.
  • Legs set wide to the side, different in length and speed; steps are signs of cerebellar gait. A patient with this disorder is still able to remain in balance by closing and opening their eyes. However, as soon as they change their posture, the balance is immediately lost.
  • Sensory ataxia in this gait disorder exhibits symptoms similar to cerebellar gait. They differ in that the patient loses their balance, barely closing their eyes.
  • If a person falls on one side while walking, we are talking about vestibular ataxia.
  • Hysteria is also often accompanied by gait disorders. The simultaneous manifestation of disturbances in balance and walking is typical. To stand without outside help, and even more so to move, a person suffering from hysteria is simply not able to.

In cases where a person has a gait disturbance, they should seek help from an orthopedist, neurologist, traumatologist, or ENT specialist. It all depends on the symptoms of gait disturbance and, of course, the reasons for its occurrence. It is necessary to undergo a detailed examination and thorough diagnosis to determine what caused the gait disturbance.

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Edward Medina
15:34 30 Jun 22
Just such an amazing staff that makes you feel like part of their family. I’ve been going there for over 5 years now... and each visit I get the very best care and treatments that I have ever received in the 20+ years that I’ve been dealing with severe debilitating migraines. Since i started seeing them the number of my migraines has dropped from 15-20 a month to 2-3 every 3 month. I highly recommend them …they will change your life!read more
Daneisha Johnson
Daneisha Johnson
22:20 19 May 22
Dr. Askari was very kind and explained everything so I could understand. The other staff were nice as well. I would... have gave 5 stars but I was a little taken aback when I checked in and had to pay 600.00 upfront. I think that should have been discussed in a appointment confirmation call or email just so I could have been more
Jean Cooper
Jean Cooper
16:54 29 Apr 22
I love the office staff they are friendly and very helpful. Dr. JODIE is very caring and understanding to your needs... and wants to help you. I will go back. would recommend Dr. Dr. Jodie to other Patients in a heart beat. The team works well more
Linda M
Linda M
19:40 02 Apr 22
I was obviously stressed, needing to see a neurologist. The staff was so patient and Dr. Ansari was so kind. At one... point he told me to relax, we have time, when I was relaying my history of my condition. That helped ease my stress. I have seen 3 other neurologists and he was the only one who performed any assessment tests on my cognitive and physical skills. At one point I couldn't complete two assessments and got upset and cried. I was told, it's OK. That's why you're here. I was truly impressed, and super pleased with the whole experience!read more
Leslie Durham
Leslie Durham
15:05 01 Apr 22
I've been coming here for about 5 years. The staff are ALWAYS friendly and knowledgeable. The Doctors are the absolute... best!! Jodie Moore is always in such a great mood which is a plus when you are already stressed. Highly recommendedread more
Monica Del Bosque
Monica Del Bosque
14:13 25 Mar 22
Since my first post my thoughts have changed here. It's unfortunate. My doctor and PA were great, but the office staff... is horrible. They never call you back when they say they will, they misinform you, they cause you too much stress wondering what's going on, they don't keep you posted. They never answer the phone. At this point I've left four messages in the last week, and I have sent three messages. Twice from their portal and one direct email. No response. My appointment is on Monday morning at 8:30am, no confirmation on my insurance and what's going on. What the heck is going on, this is ridiculous!I've given up... the stress her office staff has put me through is just not worth it. You can do so much better, please clean house, either change out your office staff, or find a way for them to be more efficient please. You have to do something. This is not how you want to run your practice. It leaves a very bad impression on your more
Ron Buckholz
Ron Buckholz
23:32 23 Mar 22
I was actually pleasantly surprised with this visit! It took me a long time to get the appointment scheduled because no... one answers your phones EVER! After a month, I finally got in, and your staff was warm, friendly, and I was totally impressed! I feel like you will take care of my needs!read more
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Steve Nabavi
16:28 16 Mar 22
It was a nice visit. Happy staff doing all they can do to comfort the patients in a very calming environment. You ask... me they are earned a big gold star on the fridge. My only complaint they didn't give me any more
Katie Lewis
Katie Lewis
16:10 10 Feb 22
Had very positive appointments with Jodie and Dr. Sheth for my migraine care. Jodie was so fast with the injections and... has so much valuable info. I started to feel light headed during checkout and the staff was SO helpful—giving me a chair, water, and taking me into a private room until I felt better. Highly recommend this practice for migraine patients, they know what they’re doing!!read more
Joshua Martinez
Joshua Martinez
16:02 10 Dec 21
I was scheduled to be checked and just want to say that the staff was fantastic. They were kind and helpful. I was... asked many questions related to what was going on and not once did I feel as though I was being brushed off. The front desk staff was especially great in assisting me. I'm scheduled to go back for a mri and am glad that I'll be going more
Isabel Ivy
Isabel Ivy
21:42 03 Nov 21
I had such a good experience with Lone Star Neurology, Brent my MRI Tech was so awesome and made sure I was very... comfortable during the appointment. He gave me ear plugs, a pillow, leg support and blanket, easiest MRI ever lol 🤣 My 72 hour EEG nurse Amanda was also so awesome. She made sure I was take care of over the 3 days and took her time with the electrodes to make sure it was comfortable for me! Paige was also a huge help in answering all my questions when it came to my test results, and letting me know her honest opinions about how I should go forth with my more
Leslie Luce
Leslie Luce
17:37 20 Oct 21
The professionalism and want to help attitude of this office was present from the moment I contacted them. The follow... up and follow through as well as their willingness to find a way to schedule my dad was above and beyond. We visited two offices in the same day with the same experience. I am appreciative of this—we spend a lot of time with doctors and this was top notch start to more
robert Parker
robert Parker
16:38 16 Apr 21
I love going to this office. The staff is friendly and helpful. The doctor is great. I am getting the best... neurological tests and treatment I have ever had. The only reason I did not give them a 5 star rating is because it is impossible to reach a live person at the office to reschedule appointments. Every time I have tried to get through to the office it says all people are busy and I am sent to a voicemail. If they could get their phone answering fixed, I would give them a strong 5 more
MaryAnn Hornbaker
MaryAnn Hornbaker
00:26 25 Feb 21
Dr. Harney is an excellent Dr. I found him friendly , personable and thorough. I evidently am an unusual case. ... Therefore he spent a Hugh amount of time educating me. He even gave me literature to further explain my condition and how to follow up. This is something you rarely get from your doctors. So I am more than please with my doctor and his more
Roger Arguello
Roger Arguello
03:05 29 Jan 21
Always courteous, professional. The staff is very friendly and always work with you to find the best appointment time.... The care team has been great. Always taking the time to listen to your concerns and to find the best more
Margaret Rowland
Margaret Rowland
01:12 27 Jan 21
I have been a patient at Lone Star Neurology for several years. Now both my adult daughters also are patients there. I... love Jodie. She is always so prompt whether it is a teleamed call are a visit in the office. She takes the time to explain everything to me and answers all my questions. I am so blessed to have Jodie as my more
Susan Miller
Susan Miller
03:01 13 Jan 21
My husband had an accident 5 years ago and Lone Star Neurology has been such a blessing to us with my husbands care.... Jodie Moore is his provider and she is amazing! Jodie is very knowledgeable, caring, and thorough. She takes her time with you, making sure your needs are met and she is happy to answer any questions you may have. Lone Star Neurology’s patients are very lucky to have Jodie providing their care. Thank you Lone Star Neurology and especially Jodie for everything you have done for us. Jodie, you are the best!read more
Windalyn C
Windalyn C
01:32 09 Jan 21
Jodie is wonderful. She is very caring and knowledgeable. I have been to over a dozen neurologists, and none were able... to help me as much as they have here. Thanks!read more
Katie Kordel
Katie Kordel
00:40 09 Jan 21
Jodi Moore, nurse practitioner, is amazing. I have suffered from frequent, debilitating headaches for almost 20 years.... She has provided the best proactive and responsive care I have ever received. My quality of life has been greatly improved by her caring approach and tenacity in finding more
Ellie Natsis
Ellie Natsis
15:41 07 Jan 21
I have had the best experience at this neurologist's office! For over a year I have been receiving iv treatments here... each month and my nurse, Bobbie is beyond wonderful!! She's so attentive, knowledgeable, caring, and detail oriented. She makes an otherwise uncomfortable experience much more pleasant and definitely puts me at ease! She also helps me with my insurance,ordering this specialty medication and dealing with the ordering process which is no easy feat.Needless to say, she goes above a beyond in every way and I'm so grateful to this office and to Bobbie for all they do for me!read more
Matt Morris
Matt Morris
15:39 07 Jan 21
Let me start by saying that I have been coming here for years. Due to my autoimmune disease, I am in this office... once every three weeks for multiple hours at a time. The office is very clean and the staff very friendly. My only complaint would be there communication via phone. They aren't the best at responding if you leave a voicemail and expect a call back. I understand that this is prob just due to the sheer number of alls they receive daily. What I can say I like the best about the office are the people. Bobby who handles my infusions is great. I never have any issues with her setting up my infusions. She is very quick to reply to messages sent via text and if she were to leave then my whole opinion of the office may change. I also enjoy people like Matt, Lauren, and Jodi. I appreciate all that they do for me and without this team I'm not sure I would be as happy as I am to visit the office as frequently as I have to. Please ensure that these folks are recognized as they are what makes my visit to this office so tolerable :).read more
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  1. March 30, 2024

    Your article on gait disorder causes is very thorough and comprehensive. It helps me find the right doctor(s) to ask for treatment. Thanks so much. More power to you!

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