Gait Problems

Gait Clumsiness

Clumsiness is when a child has poor co-ordination and may have difficulty carrying out tasks that involve fine motor skills such as handling small objects. In the case of gait clumsiness, they will experience difficulty with the gross motor skill of walking. This can greatly reduce the independence of the child.

What causes gait clumsiness in children?

There are often no identifiable causes for clumsiness problems but they can happen as a result of other problems such as learning difficulties or behavioral disorders.

What are the symptoms of gait clumsiness in children?

Some of the main signs to look for with walking are:

    • Tripping
    • Taking uneven steps
    • Problems with balance

What can physical therapy do to help children with gait clumsiness?
Physical therapy treatment will mainly consist of movement exercises and practice to improve motor skills. Treatment will be very functionally based so that improvements can be made in the child’s walking. There will also be advice on long term management of the problem so that it improves everyday life and development for the child and promotes independence.

Summary

Clumsiness can make everyday life very difficult for children and their development and independence can be greatly affected. Physical therapy can help to improve clumsiness.

Falling Over

Pediatric falling over is when a child has regular falls during walking. This can be very limiting for a child as it reduces their ability to become more independent as the child will need constant supervision. There is also a risk of injury to the child from regular falls.

What causes a child to fall over?
Children falling over regularly can be caused by a range of things, including:
      • Poor balance
      • Proprioceptive problems
      • Lack of motor control
      • Visual problems
      • Sensory problems
What are the symptoms of falling over in children?

The symptoms alongside a child falling over may include:

        • Unsteady gate
        • Dizziness
        • Feeling light headed
        • ‘Spinning vision’
        • Tripping
        • Dragging feet
        • Walking into objects
          What can physical therapy do to help children with falling over?

          Physical therapy can help to improve balance and motor problems and reduce the number of times a child falls. Physical therapy treatments for pediatric falls include:

        • Proprioceptive exercises
        • Progressive walking practice
        • Leg muscle strengthening exercises
        • Balance exercises
          Summary

          Pediatric falls can occur as a result of several different problems. These can include proprioceptive, motor and visual problems. This can make it difficult for a child to develop walking skills and independence. There are several other symptoms that a child can display whilst walking. Physical therapy is mainly aimed at balance exercises and progressive walking practice

Toe Walker

Pediatric toe walking is when a child walks on their tip toes rather than on their whole foot. This is relatively common and normally resolves by the time a child reaches school, however if it does not then it can cause problems in the future. It can cause biomechanical problems and altered muscle lengths which can cause pain later on in the child’s life.

What causes a child to toe walk?

  • Toe walking in children can be caused by factors such as:
  • Muscle tightness (especially calf)

 

Joint stiffness

  • Gait development problems
  • Growth spurts
  • Neurological conditions

 

What are the symptoms of toe walking in children?

There can be no symptoms with pediatric toe walking but it can cause some symptoms such as:

 

  • Pain in feet
  • Pain in knees
  • Pain in tightness in legs when walking or sitting
  • Toe walking can also cause future problems such as:
  • Gradual development of pain
  • Pain during exercise
  • Muscle length problems later in life
  • Biomechanical problems later in life causing pain or problems in other areas

 

What can physical therapy do to help children who toe walk?

Physical therapy treatment can be very effective to prevent pediatric toe walking and problems arising in the future. Physical therapy treatment may include:

  • Gait re-education
  • Stretching exercises
  • Joint mobility exercises
  • Muscle imbalance correction exercises
  • Muscle strengthening exercises
Summary

Pediatric toe walking can be common but can be resolved unless it is due to a neurological problem, in which case it may not be resolved. If it does not then it can cause problems for the child in the future such as pain and imbalances throughout the legs and hips. Toe walking is mainly caused muscle tightness or joint stiffness. These problems can be effectively treated by stretching exercises, joint mobility exercises and gait re-education. This will help the child to walk normally and prevent future problems occurring.

Poor Balance
Pediatric poor balance is when a child has difficulty maintaining their balance and this can create difficulties for the child. They may have problems with standing balance in which case it can be difficult for the child to walk or to learn to walk and there is a high risk of falls. The child may also have problems with sitting balance in which case the child may find it difficult to sit up straight or to reach for objects. This can severely affect a child’s ability to become more independent.

What causes poor balance in children?

Poor balance in children can be caused by several factors including:

      • Vestibular problems
      • Perceptual problems
      • Proprioception problems
      • Nerve problems
      • Cerebellum problems
      • Neurological problems
      • Visual problems
      • Developmental problems
      • Sensory problems
      • Coordination problems
What are the symptoms of poor balance in children?

Poor balance may be displayed through symptoms including:

        • Unsteady gate
        • Dizziness
        • Falling over more than usual
        • Feeling light headed
        • ‘Spinning vision’
What can physical therapy do to help children with poor balance?

Physical therapy can do a lot for children with balance problems and help to improve their walking. Physical therapy treatments for balance problems include:

          • Proprioceptive exercises
          • Sitting balance exercises
          • Progressive walking practice
          • Leg muscle strengthening exercises
          • Balance exercises
          • Gross motor exercises
Summary

Pediatric balance problems can be caused mainly by vestibular, proprioceptive or nerve problems. Balance problems can make it difficult for a child to walk or even to reach for objects when sitting and this can severely reduce a child’s ability to become more independent. Physical therapy treatment is aimed at improving the child’s balance by using walking practice and balancing exercises so that walking becomes easier.