Abasia: types and characteristics of this disability

Abasia is a health disorder that affects the ability to walk. Let's see what it looks like.

There are different disorders or injuries that can prevent or hinder a person's ability to walk.

One of the ones we can find is abasia.. Next we will discover what characteristics this pathology has, how it can be originated and which are the possible treatments that can be applied to obtain an improvement.

What is abasia?

The abasia is a medical disorder that refers to a lack of capacity in the subject that suffers it to coordinate the movements necessary to be able to walk.which would be a form of ataxia. Because of this, the action of standing or taking steps becomes difficult or impossible, depending on the severity of the abasia in the subject.

Those who can walk do it in an erratic and clumsy way, being very likely to fall to the ground, because the impossibility of coordination makes the person need a titanic effort to link several steps in a row, if they manage to do it.

One of the problems that makes this pathology prevents the patient from walking is that the steps that are managed to take do not keep a general trend in terms of distance, so that sometimes shorter and sometimes longer steps are taken randomly, preventing regular progress, which makes the patient lose balance frequently.

Sometimes, the abasia can be accompanied by another movement deficit known as astasia, which implies a lack of ability to move in a regular way.and which implies a lack of ability to remain upright, i.e., standing, without external help (someone to hold him or something to lean on).

Organic causes

Abasia arises from damage to certain brain regions, and can have a diverse origin. It can be caused, for example, by a stroke, i.e. a cerebrovascular accident, which would leave a part of the brain involved in the movements necessary for walking without oxygen.i.e. a cerebrovascular accident, which would leave a part of the brain involved in the movements necessary for walking without oxygen.

It can also be caused by a disease known as hydrocephalus, which alters the pressure levels in the brain.which alters the pressure levels of the brain due to an excess of cerebrospinal fluid surrounding this organ, and therefore can also damage part of its tissues, generating different pathologies depending on the affected area. One of them would be abasia.

Another of the diseases that could end up deriving in a difficulty to coordinate the steps would be Parkinson, one of the best known neurological pathologies. When suffering a progressive degeneration of the neuronal tissue, a moment may come when we suffer damage to the critical points of the brain that allow us to walk, beginning to suffer, from that moment, from abasia.and, from that moment on, we begin to suffer from abasia.

There are less known diseases, such as Guillain-Barré syndrome, which are also sometimes responsible for triggering the disorder in question. In this case we would be talking about an autoimmune disease, which gradually causes paralysis of the limbs, making it increasingly difficult for the person to walk, in addition to many other symptoms such as loss of sensitivity.

However, in the case of Guillain-Barré syndrome, the patient's ability to recover is very good. As a rule, up to 90% of those affected by this disorder usually improve and recover almost completely approximately twelve months after the onset of symptoms.

Another reason for abasia may be any damage affecting the cerebellum, and more specifically in the part of the vermis, a tissue that links both hemispheres of the cerebellum itself, and which is involved in the conscious proprioceptive processes of the individual.The vermis, a tissue that connects both the two hemispheres of the cerebellum itself, and which is involved in the conscious proprioceptive processes of the individual.

Phobias

We have made a tour of a multitude of diseases and organic injuries that could generate, among many other symptoms, an abasia. However, these are not the only ways in which a person can have serious problems to stand up and walk.

And we must not lose sight of the psychological part of the subject and how powerful some irrational fears, such as phobias, can be. In this sense, there are several types of phobias that directly or directly affect the person's ability to move around using his or her feet. using their feet.

Basophobia

One of them would be basophobia or basiphobia, a phobia consisting of a terrible fear of tripping and falling. a terrible fear of tripping and falling while we are walking, which blocks the subject in such a way that it can force him to remain seated or lying down all the time so as not to see the fear that frightens him fulfilled, which would be another form of abasia.

It occurs especially in older peopleIt is especially common in older people, who have already begun to suffer a degenerative process and do not feel safe to walk, because they fear the consequences of a possible fall, which could lead to serious injuries such as a broken hip or other bones.

It is also possible to have acquired this phobia because of a real fall, which has so collapsed the subject's processing capacity that his brain has established not walking as a method to avoid suffering such damage again. This is a very common origin in several types of phobias (having suffered a real harm and therefore avoiding at all costs the behavior that caused that first incident, so as to never experience something like that again).

Stasisiphobia

Another fear very similar to the previous one would be stasisiphobia, which instead of walking, refers to the very fact of being on one's feet, refers to the very fact of standingTherefore, it would also be limiting the other behavior, since, logically, it is not possible to walk if one is not standing upright.

In addition to stasisiphobia, other terms can also be found to refer to this same phobia that is causing the abasia by means of psychological factors. Some of them would be ambulophobia, stasiophobia or stasiophobia.

Stasobasophobia

In addition, stasyphobia can occur together with basophobia, in what is known by the clinical term stasobasophobia, a type of multiple phobia in which both behaviors are affected.

On the one hand, the person would be unable to stand up, because of the terror that the idea represents. On the other hand, the person would also be unable to consider walking, since this action, by itself, also provokes fears in the person, who is therefore unable to walk at all. is unable to perform any task that involves moving his or her legs..

Types

Within the abasias that have an organic basis behind, there is a wide typology according to the implications that this restriction of the movement of the legs has. We are going to know the different types that we can find.

1. Atactic abasia

On the one hand we would find the atactic abasia, one in which the subject experiences a lack of certainty when moving in the legs..

2. Choreic abasia

Choreic abasia, on the other hand, would be triggered by chorea (involuntary movements) affecting the person's lower extremities.

3. Paralytic abasia

We would also find the paralytic type of abasiacaused by an inability of the patient to move the muscles of the legs and therefore suffer from an inability to walk.

4. Spastic abasia

This type of abasia, the spastic one, would be produced when a dysfunction of the organism causes the muscles of the legs (at least those, since they are the ones we are dealing with) to remain contracted all the time, making movement difficult.therefore hindering the voluntary movement of the same ones.

5. Spasmodic abasia

The spasmodic abasia is similar to the previous type, but in this case the muscles do not have to be constantly tense.Instead, the person would suffer from involuntary spasms that would contract and relax them randomly.

6. Tremulous abasia

In the case of tremulous abasia, all the musculature involved in the movements required to take steps would suffer from constant tremors, which would make it difficult for the individual to walk. This modality is also known as tremulous abasia..

7. Abasia with astasia

We have already mentioned before that abasia can appear only as the difficulty to move the legs to walk, but it can also be accompanied by astasia, with which the individual would not even have the ability to stand up and stand, or he would do it but with great difficulty.

This type of abasia is also called Blocq's disease.Blocq's disease, known by this name because it was a disorder first described by the French physician Paul Blocq at the end of the 19th century.

In this case we would be talking about a type of ataxia in which the automatic capacity that we have to perform the movements involved in the act of walking would be lost, but the curious thing is that when lying down, he would be able to move his legs and his different Muscle groups without any problem..

In this case, the origin of the pathology would be in the substantia nigra of the basal ganglia, as we had already anticipated in the list of possible causes for some types of abasia.

Bibliographical references:

• Munford, P.R., Paz, G. (1978). Differential attention in the treatment of astasia-abasia. Journal of Behavior Therapy and Experimental Psychiatry. Elsevier.
• Okun, M.S., Koehler, P.J. (2007). Paul Blocq and (psychogenic) astasia abasia. Official journal of the Movement Disorder.
• Sinel, M., Eisenberg, M.S. (1990). Two unusual gait disturbances: astasia abasia and camptocormia. Archives of physical medicine and Rehabilitation.
• Stickler, G.B., Cheung-Patton, A. (1989). Astasia-Abasia: A Conversion Reaction Prognosis. Clinical pediatrics.