Abnormalities of Posture and Movement

  • John G. Nutt


Alterations of posture and gait commonly accompany aging and can be indicators of the health and biologic age of an individual. They also affect quality of life by decreasing confidence, restricting mobility, and causing injuries. Posture and gait can be compromised by cardiovascular, arthritic, and orthopedic disorders, but are probably most commonly impaired by neurologic dysfunction. The neurologic disturbances that produce postural and gait abnormalities can be categorized under three headings: (1) afferent or sensory dysfunction, (2) efferent or motor dysfunction, and (3) central or integrative dysfunction.


Essential Tremor Tardive Dyskinesia Gait Disturbance Hemifacial Spasm Focal Dystonia 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Nutt JG, Marsden CD, Thompson PD. Human walking and higher level gait disorders, particularly in the elderly. Neurology. 1993; 43: 268–279.PubMedCrossRefGoogle Scholar
  2. 2.
    Elble RJ, Hughes L, Higgins C. The syndrome of senile gait./Neurol 1992; 239: 71–75.Google Scholar
  3. 3.
    Murphy J, Isaacs B. The post-fall syndrome: a study of 36 elderly patients. Gerontology. 1982; 82: 265–270.CrossRefGoogle Scholar
  4. 4.
    Fisher CM. Hydrocephalus as a cause of disturbances of gait in the elderly. Neurology. 1982; 32: 1358–1363.PubMedCrossRefGoogle Scholar
  5. 5.
    Koller WC, Wilson RS, Glatt SL, et al. Senile gait: correlation with computed tomographic scans. Ann Neurol. 1983; 13: 343–344.PubMedCrossRefGoogle Scholar
  6. 6.
    Vanneste J, Augustijn P, Dirven C, Tan WF, Goedhart ZD. Shunting normal-pressure hydrocephalus: do the benefits outweigh the risks? A multicenter study and literature review. Neurology. 1992; 42 (l): 54–59.PubMedCrossRefGoogle Scholar
  7. 7.
    Jenkyn LR, Reeves AG. Neurologic signs in uncomplicated aging (scenescence). Semin Neurol. 1981; 1: 21–30.CrossRefGoogle Scholar
  8. 8.
    Horak FB, Shupert CL, Mirka A. Components of postural dyscontrol in the elderly: a review. Neurobiol Aging. 1989; 10: 727–738.PubMedCrossRefGoogle Scholar
  9. 9.
    Tinetti ME, Baker DI, McAvay G, et al. A multifactorial intervention to reduce the risk of falling among elderly people living in the community. N Engl J Med. 1994; 331: 821–827.PubMedCrossRefGoogle Scholar
  10. 10.
    Kurland LT. Epidemiology: incidence, geographic distribution and genetic considerations. In: Field WJ, ed. Pathogenesis and Treatment of Parkinsonism. Springfield, IL: Charles C. Thomas; 1958: 5–49.Google Scholar
  11. 11.
    Rajput AH. Frequency and cause of Parkinson’s disease. Can J Neurol Sci. 1992; 19: 103–107.PubMedGoogle Scholar
  12. 12.
    Agid Y. Parkinson’s disease: pathophysiology. Lancet. 1991; 337: 1321–1327.PubMedCrossRefGoogle Scholar
  13. 13.
    Alvord EC. The pathology of parkinsonism. In: Minekler J, ed. Pathology of the Nervous System. New York: McGraw- Hill; 1968: 1152–1161.Google Scholar
  14. 14.
    Gibb WRG. Dementia and Parkinson’s disease. Br J Psychiatry. 1989; 154: 596–614.PubMedCrossRefGoogle Scholar
  15. 15.
    Boiler F, Mizutani T, Roessman U, et al. Parkinson disease dementia and Alzheimer disease: clinicopathological correlations. Ann Neurol. 1980; 7: 329–335.CrossRefGoogle Scholar
  16. 16.
    Hakim AM, Mathieson G. Dementia in Parkinson’s disease: a neuropathologic study. Neurology. 1979; 29: 1209–1214.PubMedCrossRefGoogle Scholar
  17. 17.
    Mayeux R, Stern Y, Rosenstein R, et al. An estimate of the prevalence of dementia in idiopathic Parkinson’s disease. Arch Neurol. 1988; 45: 260–262.PubMedCrossRefGoogle Scholar
  18. 18.
    Mayeux R, Chen J, Mirabello E, et al. An estimate of the incidence of dementia in idiopathic Parkinson’s disease. Neurology. 1990; 40: 1513–1517.PubMedCrossRefGoogle Scholar
  19. 19.
    Brown RG, Marsden CD. Neuropsychology and cognitive function in Parkinson’s disease: an overview. In: Marsden CD, Fahn S, eds. Movement Disorders. 2nd ed. Stoneham, MA: Butterworths; 1987: 99–123.Google Scholar
  20. 20.
    Cedarbaum JM, McDowell FH. Sixteen-year follow-up of 100 patients begun on levodopa in 1968: emerging problems. Adv Neurol. 1986; 45: 469–472.Google Scholar
  21. 21.
    Critchley M. Arteriosclerotic parkinsonism. Brain. 1929; 52: 23–82.CrossRefGoogle Scholar
  22. 22.
    Meyer JS, Barron DW. Apraxia of gait: a clinico-physiological study. Brain. 1960; 83: 261–284.CrossRefGoogle Scholar
  23. 23.
    Estanol BV. Gait apraxia in communicating hydrocephalus. J Neurol Neurosurg Psychiatry. 1981; 44: 305–308.PubMedCrossRefGoogle Scholar
  24. 24.
    Thompson PD, Marsden CD. Gait disorder of subcortical arteriosclerotic encephalopathy: Binswanger’s disease. Mov Disord. 1987; 2: 1–8.PubMedCrossRefGoogle Scholar
  25. 25.
    Bannister R, Oppenheimer DR. Degenerative diseases of the nervous system associated with autonomic failure. Brain. 1972; 95: 457–474.PubMedCrossRefGoogle Scholar
  26. 26.
    Steele JC. Progressive supranuclear palsy. Brain. 1972; 95: 693–705.PubMedGoogle Scholar
  27. 27.
    Pearce J. The extrapyramidal disorder of Alzheimer’s disease. Eur Neurol. 1974; 12: 94–103.PubMedCrossRefGoogle Scholar
  28. 28.
    Quinn NP, Marsden CD. The motor disorder of multiple system atrophy. J Neurol Neurosurg Psychiatry. 1993; 56: 1239–1242.PubMedCrossRefGoogle Scholar
  29. 29.
    Scully RE, Mark EJ, McNeely BU. Case records of the Massachusetts General Hospital: weekly clinicopathological exercises—presentation of CASE 38–1985. N Engl J Med. 1985; 313: 739–748.CrossRefGoogle Scholar
  30. 30.
    Marsden CD, Parkes JD. Success and problems of long-term levodopa therapy in Parkinson’s disease. Lancet. 1977; 1: 345–349.PubMedCrossRefGoogle Scholar
  31. 31.
    Fahn S, Calne DB. Considerations in the management of parkinsonism. Neurology. 1978; 28: 5–7.PubMedCrossRefGoogle Scholar
  32. 32.
    Markham CH, Diamond SG. Long-term follow-up of early dopa treatment in Parkinson’s disease. Ann Neurol. 1986; 19: 365–372.PubMedCrossRefGoogle Scholar
  33. 33.
    Cedarbaum JM, Gandy SE, McDowell FH. “Early” initiation of levodopa treatment does not promote the development of motor response fluctuations, dyskinesias, or dementia in Parkinson’s disease. Neurology. 1991; 41: 622–629.PubMedCrossRefGoogle Scholar
  34. 34.
    Weiner WJ, Factor SA, Sanchez-Ramos JR, et al. Early combination therapy (bromocriptine and levodopa) does not prevent motor fluctuations in Parkinson’s disease. Neurology. 1993; 43: 21–27.PubMedCrossRefGoogle Scholar
  35. 35.
    Swanson PD. Drug treatment of Parkinson’s disease: Is “polypharmacy” best ? J Neurol Neurosurg Psychiatry. 1994; 57: 401–403.PubMedCrossRefGoogle Scholar
  36. 36.
    Parkinson Study Group. Effect of deprenyl on the progression of disability in early Parkinson’s disease. N Engl J Med. 1989; 321: 1364–1371.Google Scholar
  37. 37.
    The Parkinson Study Group. Effects of tocopherol and deprenyl on the progression of disability in early Parkinson’s disease. N Engl J Med. 1993; 328: 176–183.Google Scholar
  38. 38.
    Marsden CD. Neurological management: Parkinson’s disease. J Neurol Neurosurg Psychiatry. 1994; 57: 672–681.PubMedCrossRefGoogle Scholar
  39. 39.
    Larsen TA, Calne DB. Essential tremor. Clin Neuro-pharmacol. 1983; 6: 185–206.Google Scholar
  40. 40.
    Koller WC, Huber SJ. Tremor disorders of aging: diagnosis and management. Geriatrics. 1989;44(5):33–36, 41.Google Scholar
  41. 41.
    Davis MB, Bateman D, Quinn NP, et al. Mutation analysis in patients with possible but apparently sporadic Huntington’s disease. Lancet. 1994; 344: 714–717.PubMedCrossRefGoogle Scholar
  42. 42.
    Swanson PD, Luttrell CN, Magladery JW. Myoclonus: a report of 67 cases and a review of the literature. Medicine (Baltimore). 1962; 41: 339–356.CrossRefGoogle Scholar
  43. 43.
    Fahn S, Marsden CD, Van Woert MH. Definition and classification of myoclonus. Adv Neurol. 1986; 43: 1–5.PubMedGoogle Scholar
  44. 44.
    Jankovic J, Ford J. Blepharospasm and orofacial-cervical dystonia: clinical and pharmacological findings in 100 patients. Ann Neurol. 1983; 3: 402–411.CrossRefGoogle Scholar
  45. 45.
    Lane JM, Wienhold P, Kinon B, et al. Prevalence of abnormal involuntary movements (“spontaneous dyskinesias”) in the normal elderly. Psychopharmacology (Berlin). 1982; 77: 105–108.CrossRefGoogle Scholar
  46. 46.
    Aminoff JJ, Dedo HH, Izdebski K. Clinical aspects of spasmodic dysphonia. J Neurol Neurosurg Psychiatry. 1978; 41: 361–365.PubMedCrossRefGoogle Scholar
  47. 47.
    Patterson RM, Little SC. Spasmodic torticollis. J Nerv Ment Dis. 1943; 98: 571–599.CrossRefGoogle Scholar
  48. 48.
    Sheehy MP, Marsden CD. Writers’ cramp: a focal dystonia. Brain. 1982; 105: 461–480.PubMedCrossRefGoogle Scholar
  49. 49.
    Jankovic J, Brin MF. Therapeutic uses of botulinum toxin. N Engl J Med. 1991; 324: 1186–1194.PubMedCrossRefGoogle Scholar
  50. 50.
    Jankovic J. The neurology of tics. In: Marsden CD, Fahn S, eds. Movement Disorders. 2nd ed. Stoneham, MA: Butterworths; 1987: 383–405.Google Scholar
  51. 51.
    Ehni G, Wollman HW. Hemifacial spasm. Arch Neurol Psychiatry. 1945;53:205–211. J.G. NuttGoogle Scholar
  52. 52.
    Janetta PJ, Abbasy M, Maroon JC, et al. Etiology and definitive microsurgical treatment of hemifacial spasm. J Neurosurg. 1977; 47: 321–328.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 1997

Authors and Affiliations

  • John G. Nutt

There are no affiliations available

Personalised recommendations