MYOPATHIC GAIT
The weakening of the hip girdle muscles, caused by myopathy muscular dystrophy, results in a myopathic gait.
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Myopathic Gait
Your upper thigh and hip muscles become weak, which results in a myopathic gait. Also, you wobble from side to side, your hip dropping with each stride, trying to make up for the weakness.
Myopathic Gait in Pregnancy
A myopathic gait has several causes, one of which includes pregnancy. For instance, pregnancy causes a number of physical changes in your body that have an impact on how you walk. In fact, it increases the synthesis of the hormone relaxin as one method of getting ready to give birth. As a result, your pelvic muscles and joints will relax as a result, making it simpler for a baby to pass through. When you are pregnant, you also put on weight. You must slightly incline your back since your center of gravity is altered by the majority of it being in your belly. After giving delivery, your gait should return to how it was before becoming pregnant.
Myopathic Gait in Muscular Dystrophy
A hereditary disorder called Duchenne muscular dystrophy (DMD) results in progressive muscle weakening. It’s one of four disorders brought on by a change in the dystrophin protein, which keeps muscle cells bound together. By the time they reach school age, children with DMD walk with a waddling stride. A milder kind of DMD called Becker muscular dystrophy (BMD) can also result in a waddling gait. Compared to DMD, it is frequently diagnosed later in life. The progress is typically slower and less predictable. DMD and BMD primarily impact boys. By the time they are 12 years old, most DMD patients need to use a wheelchair. Prior to that, certain mobility aids can help in walking. These incorporate:
- Supporting ankle and foot braces
- Achilles tendon stretching braces used at night
- An upright walker
- wheelchairs with an adjustable height for standing
QUESTIONS AND ANSWERS
What constitutes a myopathic gait, and what causes it?
A myopathic gait refers to a walking pattern that results from muscle weakness or dysfunction. It normally occurs by a primary muscle disorder or myopathy. Myopathies can have various underlying causes, including genetic mutations, metabolic disorders, inflammatory conditions, or toxic exposures. Doctors will determine the cause of a myopathic gait through medical evaluation and diagnostic testing.
How do doctors manage and treat myopathic gait in children?
The management of a myopathic gait primarily depends on the underlying cause and severity of the condition. Treatment may involve:
- Physical therapy: To improve muscle strength and coordination.
- Assistive devices: Such as braces, orthotics, or mobility aids to support walking.
- Medications: In some cases, doctors will prescribe medications to manage symptoms or address the underlying cause.
- Lifestyle modifications: Adaptations to daily activities and exercise routines to accommodate the child’s muscle weakness.
- In certain cases, doctors may treat certain patients with enzyme replacement therapy for metabolic myopathies, or gene therapy for some genetic myopathies.
What is the long-term prognosis for my child with a myopathic gait?
- The long-term outlook for a child with a myopathic gait varies widely based on the underlying cause and its severity. Some myopathies are relatively stable, while others may progress over time. It’s essential to work closely with healthcare professionals to monitor your child’s condition and adapt the treatment plan as needed. Many children with myopathic gait can lead fulfilling lives with appropriate support and management.
Parents should seek guidance from pediatricians, neurologists, and physical therapists who specialize in treating neuromuscular conditions to develop a comprehensive care plan for their child. It’s important to address not only the physical aspects of a myopathic gait but also the child’s emotional and social well-being to ensure they can enjoy the best possible quality of life.
Schedule an appointment at Medical City Children’s Orthopedics and Spine Specialists if your child walks with an unusual gait
Myopathic Gait in Toddlers
Under the age of three, a myopathic gait is typical. When a youngster is first starting to walk, their feet are spread out and pointed out. As they take several quick steps, this aids in maintaining their equilibrium. Ask your child’s physician about it if they are older than 3 and still walk with a myopathic gait. Among the illnesses that might manifest in children older than 3 as having a myopathic gait are:
- Developmental dysplasia of the hip
- A muscle sickness, such as DMD
- Cerebral palsy is an illness that disturbs movement and balance
- Lower back curvature that is noticeably more inward, or lumbar lordosis. In children, this often fades away on its own.
Myopathic Gait in Spinal Muscular Atrophy
A genetic condition called spinal muscular atrophy (SMA) causes the spinal cord’s nerve cells to die. The peripheral nervous system, the central nervous system, and voluntary muscular movements are all impacted. Mild to severe SMA symptoms are possible. In general, the severity of the ailment increases with the onset of symptoms. Autosomal dominant spinal muscular atrophy, lower extremity-predominant type 2 is one kind of SMA. Early infancy is when signs of this illness first manifest, mostly affecting the thigh muscles. Additional signs include:
- Delayed walking
- Difficulty walking
- Foot deformities
- Loss of some reflexes
Causes
The weakening of the hip girdle muscles, which is most frequently caused by myopathy and is most distinctively caused by muscular dystrophy, results in a myopathic gait. When walking, the pelvis needs to be stabilized by the hip abductor muscles, particularly the gluteus Medius. Sometimes this walking style is referred to as a gluteus Medius gait. Because the hip abductors on the opposite side are weak, Trendelenburg’s sign causes an irregular pelvic drop on the side of the swing leg. As the stance leg adducts, the hip on the afflicted side juts laterally rather than remaining in a stable posture. In contrast to the hip on the swing side, which sags downward, the stance side hip moves laterally.
When there is bilateral weakness, the hip on the side of the swing leg droops, causing an accentuated pelvic swing with every stride and a “waddling” gait. Exaggerated pelvic swings are frequently referred to as “sexy” gaits because they mimic runway models’ strides. This walking pattern can take on odd shapes, especially with FSH dystrophy. The patient’s shoulders are flung back and his or her pelvis is shoved forward as they walk. Particularly prevalent in people with facioscapulohumeral muscular dystrophy is this gait style. Also take note if there is a protruding belly, lumbar hyperlordosis, and forward-facing shoulders. In order to prevent the patient from falling forward due to weak back and hip extensors, this posture shifts the center of gravity behind the hips.
How Is Myopathic Gait Diagnosed?
Your doctor will examine you physically and discuss your symptoms with you. They could also verify:
- Muscle power, tone, and synchronization
- Check your spine and neck for abnormalities
- Determine your risk of falling
- Your heart rate while sitting, standing, and lying down
- Your vision
- In the case of neurological conditions like muscular dystrophy
- Arthritis
Your doctor may recommend additional testing or imaging procedures based on the results.
How Is Myopathic Gait Treated?
The etiology of a waddling gait will determine the course of treatment. Some illnesses could get better on their own. Other medical possible aids include:
- Balance aids like canes and walkers
- Physical therapy helps improve flexibility, balance, and strength
- Physical therapy to prevent falls
- Leg braces or splints to aid in proper foot alignment.
- Medicine
- Surgery
- prosthetics
Choosing Medical City Children’s Orthopedics and Spine Specialists
Always consult with your doctor if your child begins to walk differently. If you come to one of our Medical City Children’s Orthopedics & Spine Specialists offices in Arlington, Dallas, Flower Mound, Frisco, and McKinney, TX our pediatric orthopedic doctors will examine your child and recommend the best treatment options available.
As previously mentioned, our doctors at the Medical City Children’s Orthopedics and Spine Specialists will examine your child. By doing so, they will determine and understand the reasons for the unusual gait. At that point, the doctor will prepare an individualized treatment plan for your child if he finds the cause of the unusual gait. Finally, the doctor will devise and formulate a plan and strategy — using the latest technology and treatments — to provide the very best methods to assist the child’s mobility.
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Footnote:
Performance Health Academy: How to identify gait abnormalities
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