Clinical Aspects of Movement Disorders: Effects on Walking and Posture

Movement disorders are a group of syndromes that include parkinsonism, chorea, dystonia, myoclonus, tremor, and tics. Many of the diseases of this group manifest disturbances of gait and posture along with other abnormalities. Parkinsonism is characterized by rest tremors, muscular rigidity, bradykinesia, flexed trunk posture, and loss of postural reflexes. Parkinson’s disease (PD) is the most prevalent of the diseases of this group and patients usually manifest problems of gait and posture in late phases. On the other hand, atypical parkinsonism diseases (multiple-system atrophy, progressive supranuclear palsy, dementia with Lewy bodies, and corticobasal ganglionic degeneration) manifest gait problems and falls very early and are much more incapacitating than PD. Vascular parkinsonism manifests itself with lower limb rigidity and bradykinesia and affects gait very early. Huntington’s disease is a genetic disorder characterized by behavioral and cognitive disturbances associated with chorea, dystonia, and loss of equilibrium. Sometimes, especially in subjects with the juvenile form of the disease, Huntington’s disease may manifest with very severe parkinsonism. Movement disorders may cause severe disturbances of posture and gait and health professionals should be attentive to them.