Ambulation in Adults with Central Neurologic Disorders

Francois Bethoux, MD, Editor
“Walking is man’s best medicine.” This quote, attributed to Hippocrates, illustrates how long health care professionals have been interested in ambulation. The therapeutic effects of walking on the body and mind are mirrored by the ill effects of impaired ambulation and limited mobility in the environment. Many ailments can lead to walking limitations, and the effects of aging on walking have been well described. At the same time, walking performance has been identified as a marker or predictor of general health, to the point that the assessment of self-selected walking speed has been proposed as the “sixth vital sign” in elderly individuals.

Central neurologic disorders (including congenital disorders, diseases, and injuries) represent a particularly challenging cause of impaired ambulation: walking limitations are usually the result of multiple neurologic impairments, and the situation is often further complicated by comorbidities, as well as psychosocial and environmental factors, and sometimes the side effects of treatments. Too often, there is no cure for central neurologic disorders, and most of the chronic damage caused to the central nervous system cannot yet be repaired. Furthermore, some of these disorders are progressive, making even maintenance of functional performance a struggle.

However, advances in various fields present us with rapidly growing opportunities to fight the consequences of central neurologic disorders on ambulation. The International Classification of Functioning, Disability, and Health provides us with a conceptual framework to describe and assess these consequences beyond the traditional biomedical model. New exercise and rehabilitation techniques, medications, and devices are being developed. Assessment techniques give health care professionals a better understanding of the pathophysiology of gait disturbances and allow them to measure ambulation limitations, as well as the results of various interventions, from the gait laboratory to the environment, including self-report measures that directly capture the experience and concerns of individuals.

The goal of this issue is two-fold: to provide the base of knowledge needed to understand the latest developments related to the pathophysiology, assessment, and rehabilitation of ambulation limitations in central neurologic disorders, and to provide up-to-date information regarding the management of walking limitations in specific disorders, including stroke, multiple sclerosis, Parkinson disease, and spinal cord injury. We hope that these articles will provide readers with information that they can use in their own practice, will entice them to learn more on this very important topic, and will drive some to contribute to the body of knowledge through further research and publications.

Only gold members can continue reading. Log In or Register to continue

Stay updated, free articles. Join our Telegram channel

Apr 17, 2017 | Posted by in PHYSICAL MEDICINE & REHABILITATION | Comments Off on Ambulation in Adults with Central Neurologic Disorders

Full access? Get Clinical Tree

Get Clinical Tree app for offline access