Change of Gait Following TBI
 

Has anyone experienced a change in their gait following their brain injury?

I have, but didn't notice it too much, but they made a big deal of it last week at the rehab clinic. They are going to send me for a vestibular assessment and physio therapy.

My stance and gait is very wide now... feet wide apart... my family says I walk like king kong! It seems to be easier to balance this way, especially at speed.

I can walk with my feet at a normal distance, but it feels like walking on a balance beam or tight rope and I'm rather unsteady and slow. Walking with one foot in front of another is just about impossible without lurching and falling down.

I can walk almost at normal speed with my feet wide apart, though I do sometimes feel a bit unsteady (dizzy isn't the right word but something like that?) if I go too fast.

Just wondered if anyone else has experienced anything similar and what was done to correct it.

Starr

Gait
 

Could be vestibular in origin but a neuro is the place to start. The vestibular system as I understand it connects your inner ear"balance" the bones in your ear"hearing" and the tiny hairs in the inner ear together. If the vestibular and ocular system "eyes" are not in sync then nausea and balance issues can result.

I have read these issues can resolve on there own. There are some people here very well versed with these same issues. I am certain some insight and suggestions will follow your post.

Hope you feel better.

It is not uncommon for a TBI subject to also walk with a tip-toe like gait. They look like they are bobbing up and down as they push off their forefoot and get a vertical lift from the push off. They plant the whole foot but over-emphasize the toe push-off.

Some doctors will use a lack of gait issues as a negative diagnosis of brain injury.

Yes, I've seen that gait before (ironically I taught therapeutic horseback riding for years, now I need therapeutic horseback riding! :rolleyes:) and that's not a problem I have.

I probably won't be seeing a neuro, the brain injury rehab clinic is run by a physiatrist and he is who I saw last week. He's the one sending me to PT and vestibular therapy. They do have a neuro on staff, but it seems unlikely Ill see him.

I hadn't ever read on here anyone talking about gait changes, so I didn't know if it was common or not.
Thanks :)
Starr

I'm curious about the therapeutic horseback riding. I've found a couple brain rehab places that utilize it, but I wonder how safe it is to teach such a risky thing to TBI survivors?? It seems awfully likely that sooner or later they could fall off and get another TBI. Not to mention that many first TBI's are obtained in a horseback riding accident.
...oohh did I just mention that?! I did, heheh... welllll I am curious about how they minimize the risks and all. ???

Riding horses is never without risk. They do minimize the risk as much as possible by only using well trained, calm horses, well trained staff and volunteers and through well maintained tack and safety equipment (helmets are mandatory).

Many riders in the programs do not ride independently, one volunteer will lead the horse and one or two will walk beside the rider and provide physical and emotional support as required.

The environment is as controlled as possible, usually within an arena or fenced outdoor ring, the footing is soft and shock absorbent. The horses are specially chosen for temperament and then time is spent training them to deal with adaptive equipment and the routine of therapeutic riding.

Anytime you get on a horse, you do run risk of falling, that's the nature of the activity. Occasionally riders do fall, but in 15 years of teaching daily, I never had a rider fall and require medical attention following a fall, with the exception of one rider that jumped prematurely off her horse, knocking her volunteer to the ground and landing on her feet, breaking an ankle.

The job of the volunteer(s) walking beside the rider is to help prevent falls and if a fall cannot be prevented, then at least minimized and brought softly to the ground.

My brain injury was caused by a fall from a horse. If I felt I would qualify for therapeutic riding, I would not hesitate to take part. There are many benefits to therapeutic riding and each individual has to weigh the risks versus benefits for themselves.

Starr

Starr did not mention this but I have read that a key value of horseback riding therapy is how it enables the brain to re-establish a cadence that is beneficial to recovery. Somehow, the brain picks up on the movements of the horse and integrates them into movements of the rider.

I use music to help re-establish the timing of my brain after a crash. Finding that timing or cadence is very important to recovery.

I hope others have been able to find this timing aid.

My best to you all.

I spent two years from 2006 onwards trainig myself to walk properly after damaging my neck after a fall. The main problem during that time was stoppig myself crabbing (leading with my left hip) and leaning to one side.

Since my fall in January where I not only damaged my head but also my knee my gait is all over the place and tend to meander as i walk this coupled with balance problems makes me look like I have had "one too many". I have had a bit of abuse from other members of the public because I walk slowly and get in their way.

Sospan,
I'm sorry you've received some abuse about your gait... that sucks.

I've had people stare at me while I walk and kids ask their parents "why does that lady walk funny"?

I did get in someone's way at Lowes and they were being impatient and sighing loudly and I stopped and turned to look at them and I said "sorry I'm holding you up, since my brain injury I have a hard time walking normally" and I stepped to the side and let them pass. Their face turned red and they were clearly embarrassed that I noticed their impatience.

Starr

OMG good for u Starr!

I would've said the same thing!

Thanks - fortuneatly still big and ugly enough to hold my own. Its always strange when you see peoples attitudes to disabled people. I was in a well known burger bar chain walking towards an empty table, walking stick in left hand and holding a tray in the other. A mother shouted to her kids to run and grab the table I was walking towards. She still didn't get it when another customer pointed out what she had just done - theres no hope for some people:winky:

Dear Starr,
I have a severe gait problem so i can relate with you. My family is always trying to get me to walk with my legs closed and it's hard. The best advice I can give you is to look forward when you walk and don't look at your feet.

Thanks bunny for the suggestion. However, looking at my feet is not the problem. I'm always looking 6-12 ft ahead to watch for changes in terrain and things that will trip me up. I wish it was that simple.
Starr

Starr,

I was just diagnosed with Ataxia in relation to my gait, balance and vertigo issues. I haven't learned a whole lot yet but at least I have a reason for it and will continue to learn more.

I was supposed to have a vestibular therapy assessment done today, but after a few basic tests, the physio decided that it was pointless to continue with the vestibular testing until we address the gait issues.

She could not believe that at 6 months following my accident it had never been suggested that I should be using an assistive device (cane, walker). But really, until my brain injury rehab clinic appointment a few weeks ago, I wasn't really that aware of what an issue my gait was.

The physio felt that my family doc really dropped the ball, but whatever. So now I have a cane that I'm to use every time I leave the house (she said it wasn't as necessary to use it inside) and hopefully the cane will provide enough stability that I will be able to slower adjust to have a narrower stance.

She's given me a bunch of exercises to work on and feels that in 3 weeks my gait should be quite improved with using the cane and by doing the exercises.

Then, if its improved at my next appointment she will try to do the vestibular assessment then.

I do feel more stable using the cane... I can only use it in my left hand, if I try it with my right, I can't seem to coordinate it with my left leg. Since its not for an orthopedic injury, she wants me to practice using it on both sides, so neither side gets too dependent on it. So I will have to work at coordinating my right hand and left leg.

The physio feels that much of the gait issue could've been avoided had someone got me using a walker early on after my fall. She said its harder to retrain to walk than it is to intervene early and prevent such issues.

Overall, I was happy enough with the appointment, this physio deals only with vestibular issues and brain injury rehab patients, mostly in a hospital setting and has for about 20 years.

Best part was not having to do the vestibular assessment that they warned me might make me feel sick and possibly vomit ;)
Starr

Seems like some positive news that there is a plan to address the symptoms one by one.

Don't worry about the cane - I was the same at first its surprisingly difficult to use initially but you soon get used to it and in my case the embarassment of using it.

Interested in the exercises for gait therapy
 

I am 4 years post TBI and have a hard time with my gait and balance. I go to balance therapy 3 days a week, but my gait has not been helped. I also notice that I become "off balance" when walking between people or things, something just throws me for a loop. I still feel that I have to choose where to put my foot and do not "automatically" walk like I did before the TBI. This past week end, my husband and I went to the UA campus to see the Tide play. I was worn out from walking, not physically, but mentally. HELP! If your therapist has given you exercises that assist you in correcting your gait, please post them or recommend a web site. Thanks, janieruth:rolleyes: