As soon as a patient enters my office, even before the formal evaluation begins, I
am observing their stance (how they stand) and gait (walking)
In normal stance, the feet are about shoulder width apart, firmly planted on the
floor in an even way; the shoulders are relaxed; the knees are straight but not
locked. The posture is upright. I observe the arms swinging as the person walks
(each arm typically swings the same amount as the other when the opposite foot is
moved). Also observed is the pattern of leg and foot movement. A neurologist will
ask herself, while observing a person walk: does the heel hit first, with the foot
rolling forward subsequently to the toe, with the toes then rising to push off for the
next step, as is normal?
Walking is an excellent exercise for most people, and uses skills we have all
learned and practiced across the span of our lifetime. It does not require a gym
membership, lessons, special equipment, a particular location, or another person
(although the latter adds to the enjoyment of walking). Walking not only maintains
and improves balance and muscle strength, it can also reduce the risk of heart
disease, cancer, and (perhaps surprisingly), dementia. In a Hawaiian study of
2,257 healthy Japanese-American men over 71 years old, men who walked least 2
miles per day (over the entire day) were much less likely to develop dementia than
those who had walked less than a quarter mile during a given day.
Many people enjoy walking for fitness in a shopping mall because the surface is
flat, the surroundings are safe, and there are no weather problems. Going to the
mall when it first opens, during weekdays, is a good time, because the mall can be
rather empty then, and convenient for people who are retired. Some malls open
very early in the morning before the stores open in order to accommodate walkers,
especially in areas where the weather is colder. Patients of mine who have
balance problems like to go to a large store such as a “mega supermarket” or
discount store where shopping carts are available, as pushing the cart gives them
additional support to prevent falling. Consider a class in Tai Chi, an exercise that
can help with balance.
am observing their stance (how they stand) and gait (walking)
In normal stance, the feet are about shoulder width apart, firmly planted on the
floor in an even way; the shoulders are relaxed; the knees are straight but not
locked. The posture is upright. I observe the arms swinging as the person walks
(each arm typically swings the same amount as the other when the opposite foot is
moved). Also observed is the pattern of leg and foot movement. A neurologist will
ask herself, while observing a person walk: does the heel hit first, with the foot
rolling forward subsequently to the toe, with the toes then rising to push off for the
next step, as is normal?
Walking is an excellent exercise for most people, and uses skills we have all
learned and practiced across the span of our lifetime. It does not require a gym
membership, lessons, special equipment, a particular location, or another person
(although the latter adds to the enjoyment of walking). Walking not only maintains
and improves balance and muscle strength, it can also reduce the risk of heart
disease, cancer, and (perhaps surprisingly), dementia. In a Hawaiian study of
2,257 healthy Japanese-American men over 71 years old, men who walked least 2
miles per day (over the entire day) were much less likely to develop dementia than
those who had walked less than a quarter mile during a given day.
Many people enjoy walking for fitness in a shopping mall because the surface is
flat, the surroundings are safe, and there are no weather problems. Going to the
mall when it first opens, during weekdays, is a good time, because the mall can be
rather empty then, and convenient for people who are retired. Some malls open
very early in the morning before the stores open in order to accommodate walkers,
especially in areas where the weather is colder. Patients of mine who have
balance problems like to go to a large store such as a “mega supermarket” or
discount store where shopping carts are available, as pushing the cart gives them
additional support to prevent falling. Consider a class in Tai Chi, an exercise that
can help with balance.
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I still have a full deck; I just shuffle slower now. ~Author Unknown
from Living Older, Living Better! by Katrina Gwinn, MD
Gait (Walking) and Balance
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