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It is critical to differentiate whether the primary problem is weakness or spasticity, thus better understanding different phenotypes of spastic gait disorders. Pelvic girdle abnormality plays a pivotal role in determining the clinical presentation of gait disorders, since it determines the body vector and compensatory kinetic chain reactions in the knee and ankle joints. Knee joint abnormality can be a mechanical compensation for hip and\/or ankle and foot abnormality. Diagnostic nerve blocks and instrumented gait analysis may be needed for diagnosing the underlying problems and developing an individualized plan of care. A wide spectrum of treatment options has been used to manage spastic gait disorders. Some are in early and investigational stages, such as neuromodulation modalities, while others are well\u2010developed, such as therapeutic exercise, ankle\u2010foot orthoses, botulinum toxin treatment, and surgical interventions. Physicians and other healthcare providers who manage spastic gait disorders should be familiar with these treatment options and should employ appropriate interventions concurrently rather than serially. The most effective treatments can be selected based on careful evaluation, inputs from patients, family, and therapists, along with appropriate goal setting. Treatment plans need to be re\u2010evaluated for effectiveness, relevance, and in concordance with disease progress. This is particularly important for patients with progressive neuromuscular diseases such as amyotrophic lateral sclerosis.<\/jats:p>","DOI":"10.1002\/mus.28402","type":"journal-article","created":{"date-parts":[[2025,4,8]],"date-time":"2025-04-08T08:14:26Z","timestamp":1744100066000},"page":"179-200","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Management Approaches to Spastic Gait Disorders"],"prefix":"10.1002","volume":"72","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0551-7442","authenticated-orcid":false,"given":"Sheng","family":"Li","sequence":"first","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, McGovern Medical School University of Texas Health Science Center \u2013 Houston  Houston Texas USA"},{"name":"TIRR Memorial Hermann  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tulsi","family":"Pandat","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, McGovern Medical School University of Texas Health Science Center \u2013 Houston  Houston Texas USA"},{"name":"TIRR Memorial Hermann  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bradley","family":"Chi","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, McGovern Medical School University of Texas Health Science Center \u2013 Houston  Houston Texas USA"},{"name":"TIRR Memorial Hermann  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Moon","sequence":"additional","affiliation":[{"name":"Jefferson Moss Magee Rehab  Elkins Park Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuel","family":"Mas","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, School of Medicine University of Puerto Rico \u2013 San Juan  San Juan Puerto Rico"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,4,8]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.0000180861.54180.FF"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.3109\/02699059309008165"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1089\/neu.2006.23.571"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-8749.2008.03250.x"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gaitpost.2016.09.026"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00401-013-1115-8"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.2010.235952"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/pmrj.12329"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1747-4949.2012.00796.x"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMcp043511"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1053\/apmr.2002.28030"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1053\/apmr.2001.19744"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.72.2.193"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/0966-6362(96)01063-6"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.3389\/fphys.2018.01021"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pmr.2012.11.010"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1113\/jphysiol.2007.146605"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.conb.2008.01.002"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbiomech.2009.03.009"},{"issue":"3","key":"e_1_2_12_21_1","first-page":"543","article-title":"The Major Determinants in Normal and Pathological Gait","volume":"35","author":"Saunders J. 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