Can anyone out there help?

I have been seeing a six year old boy for some time, with very limited
success.His gait is extremely unstable, he is very unbalanced and falls
frequently. Intermittently, his right foot fails to clear the ground during
swing phase and is instead dragged behind him.

His birth was prolonged but normal, his diet is normal and he has a younger
brother who exhibits none of the signs of the patients disorder.  There is
no significant family history.

This young man is also receiving ongoing treatment from a chiropractor, a
neurologist, a physiotherapist and his family practitioner.  He first
walked at 14 months after having used a baby walker and a jumping jack.
Now, at six, he is still unable to hop or skip but has developed a unique,
albeit very slow, running style.  Both feet are extremely pronated, his
head tilts to the right during locomotion, his right arm swing is
non-exsistent, both knees are internally rotated and there is an early heel
lift on both sides.  He wears a lacing shoe at all times and the physio has
given him splints to help with balance although we are not in agreement as
to the advantages of these.

Conduction tests have shown nothing abnormal and muscle testing shows a
moderate weakness on the right tibialis anterior.

He is currently on an exercise program involving toe-walking, wobble board
exercises and various strengthening exercise.  However, progress has been
very limited and the parents are very keen to explore any avenue that might
help their child's progress.  they are happy to travel if nesisary or to
adopt any changes to his lifestyle and treatment that might help.

In the past six months he has progressed from managing around 6 steps
before tripping to managing 12 - 15 steps now, but his gait remains
unstable.

Your thoughts would be greatly apreciated.

Regards

Dave Cashley.


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