SCISSOR GAIT
The manner in which a child with cerebral palsy walks is often that of a Scissor Gait. The walking is characteristic of how a marionette walks.
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Scissor Gait
The effects of cerebral palsy (CP) can often be seen in how children learn to walk, as gait can be significantly altered or impaired as a result of this disorder. The development of the scissor gait identifies one of the movement problems that may occur from cerebral palsy. Mobility may become difficult, painful, and uncharacteristically sluggish when walking in this manner. The scissor gait appears as a type of abnormal gait that frequently occurs when a child has spastic cerebral palsy. The cause of the gait occurs when an upper motor neuron lesion links to the disorder. This walking style can remind parents of a puppet walking or moving. In addition, hypertonia causes the legs, hips, and pelvis to flex to varying degrees, giving the appearance of crouching.
Tight adductor muscles cause irregular walking, which causes the knees and thighs to cross in a scissors-like motion, while the opposing muscles, the abductors, become weak from lack of use. Unless the plantar flexor muscles become freed via an orthopedic surgical treatment, the child will continue to walk on tiptoes.
No matter how mild or severe the spastic CP condition appears, these symptoms, always occur in some way or to some extent.
Symptoms
- Excessive swinging leg adduction and stiffness.
- The ankle bends in a plantar fashion.
- Flexed knees.
- Internal hip rotation and adduction.
- Constricted assisting motions of the upper limbs during walking due to increasing contractures of all spastic muscles.
Ineffective management of the scissor gait may provide the following risks:
- Growth restrictions or developmental defects as a result of unequal muscular pull
- Poor balance and occasional falling.
- Pressure sores develop as a result of the frequent rubbing of the knees.
- Restricted motion because of stiff joints.
- Discomfort brought by persistent muscular tension and joint stress.
- Loss of mobility when walking
QUESTIONS AND ANSWERS
What constitutes scissor gait, and why does my child walk with this pattern?
Scissor gait refers to a walking pattern where a child’s legs cross over each other as they walk. The gait usually indicates underlying conditions, including cerebral palsy, muscle weakness, or spasticity. The doctor will perform a thorough examination and may order tests to determine the cause of the scissor gait. Understanding the underlying condition becomes crucial for developing an appropriate treatment plan.
What are the treatment options for scissor gait, and can it be corrected?
Treatment for scissor gait depends on the underlying cause. It may involve physical therapy to improve muscle strength, flexibility, and coordination. In some cases, orthopedic interventions, braces, or assistive devices may be recommended to help correct the gait pattern. The specific treatment plan will be tailored to the child’s individual needs and the underlying condition contributing to the scissor gait.
What is the long-term outlook for my child's walking pattern, and will they be able to walk normally as they grow?
The long-term outlook for a child with scissor gait depends on the underlying cause and the effectiveness of the chosen interventions. In some cases, with appropriate treatment and rehabilitation, children can significantly improve their gait and function more normally. Regular follow-up with healthcare professionals, including orthopedic specialists and physical therapists, is essential to monitor progress and make adjustments to the treatment plan as needed. Early intervention and consistent management often contribute to better outcomes.
Parents should seek guidance from healthcare professionals who can conduct a comprehensive evaluation of the child’s gait pattern and provide personalized recommendations based on the specific underlying condition.
Walking differently can be a medical indication that something is wrong. Make an appointment with one of our pediatric orthopedists to ensure everything is fine
Treatments for Scissoring Gait
Our doctors believe that early intervention will significantly improve walking and prevent the development of a scissor gait in cerebral palsy children. A two-step program will fix a scissor gate. The first priority will get the muscles to easily contract and relax — spasticity must first be reduced. The second step will get the child to regularly work on improving their walking form through home exercises and physical therapy. Some treatments may work better than others for your child’s spasticity, depending on the severity. Determine the most efficient and advantageous course of treatment by speaking with your child’s physician or physical therapist.
Medications
For short spasticity alleviation, muscle relaxants like baclofen can help decrease muscular hyperactivity. Typically, muscle relaxants administered orally, taken several times daily, only temporarily relieve spasticity. Muscle relaxants can influence the entire body and might make your child feel drowsy, worn out, or weak. For people who simply have spasticity in their legs, this might not be the best option. Another option is an intrathecal pump that becomes surgically installed and can also be used to give medicine to reduce the problem. The danger of adverse effects is decreased since the muscle relaxant in the pump may be administered in lesser dosages because it is directly delivered to the spinal cord.
Surgery
Kids with cerebral palsy who have various operations may experience less spasticity. Surgery in our practice becomes the last option after all other strategies fail or there is no alternative. For example, adductor lengthening surgery may be advised for children who walk with a scissoring gait as there is no alternative. The muscles in the inner thighs need to be lengthened. A selected dorsal rhizotomy procedure can lessen spasticity. By severing the hyperactive nerve fibers, a surgeon can stop and prevent muscle contractions. The muscles won’t be spastic once the nerve fibers are severed since they can’t grow again.
Physical Therapy
Children who always walked with a scissoring gait may do so even after their stiffness has been greatly decreased. Although, Surgery, nerve blockers, and muscle relaxants may reduce stiffness, they won’t teach your child how to walk correctly. Therefore, it will seem strange for your child to walk normally if they have walked for an extended period with a scissoring gait. So, children must undergo physical therapy and adopt new walking techniques in order to correct their form. In conclusion, a physical therapist will evaluate your child’s mobility and develop a special exercise program for them to work on their gait. The more children walk with a proper form, the more their brain circuits may get stronger and the movement pattern will feel more natural.
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 option to repair the problem and get your child back playing.
As previously mentioned, our doctors at the Medical City Children’s Orthopedics and Spine Specialists, will examine your child and understand the reasons for an 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. After correcting the problem, your child will resume his or her favorite activities. For athletes, it may take up to a year before they may resume their sport.
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Footnote:
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