Abnormal Gait (Exam 1)

Question 1

What are the most common conditions associated with hemiplegic gait?

Answer 1

stroke or unilateral UMN lesion

Question 2

What are the most common conditions associated with spastic diplegic gait?

Answer 2

-spastic cerebral palsy
-bilateral UMN lesion
-wilson’s disease

Question 3

What are the most common conditions associated with neuropathic gait?

Answer 3

LMN lesions such as disc herniations

Question 4

What are the most common conditions associated with myopathic gait?

Answer 4

muscular dystrophy

Question 5

What are the most common conditions associated with parkinsonian gait?

Answer 5

Parkinson’s disease

Question 6

What are the most common conditions associated with choreiform gait, also known as chorea?

Answer 6

Huntington’s disease

Question 7

What are the most common conditions associated with ataxic gait?

Answer 7

-stroke
-MS
-ataxic cerebral palsy
-Friedreich’s ataxia
-damage to cerebellum

Question 8

Which gait is this?
-patient has unilateral weakness and spasticity with the upper extremity held in flexion and the lower extremity in extension
-the foot is in extension so the leg is “too long” and the patient will have to circumduct or swing their leg to step forward
-holds upper extremity flexed to the elbow and the hand with the thumb tucked under the closed fingers, this is called “cortical fisting”

Answer 8

hemiplegic gait

Question 9

Which gait is commonly associated with an UMN lesion, usually caused by a cerebral stroke?

Answer 9

hemiplegic gait

Question 10

Which gait is this?
-patient has spasticity in the lower extremities greater than the upper extremities
-hips and knees are flexed and adducted with the ankles extended and internally rotated
-when the patient walks, both lower extremities are circumducted and the upper extremities are held in a mid or low guard position
-bilateral circumduction of the lower extremities is called a scissors gait

Answer 10

spastic diplegic gait

Question 11

Which gait is usually seen with bilateral periventricular lesions (spastic cerebral palsy)? The legs are more affected than the arms bc the corticospinal tract axons that are going to the legs are closest to the ventricles

Answer 11

spastic diplegic gait

Question 12

Which gait is this?
-most often seen in peripheral nerve disease or LMN lesions where the distal lower extremity is most affected
-because the foot dorsiflexors are weak, the patient has a high stepping gait (foot drop or steppage gait) in an attempt to avoid dragging the toe on the ground

Answer 12

neuropathic gait

Question 13

Which gait is this?
-with muscular diseases, the proximal pelvic girdle muscles are usually the most weak
-bc of this the patient will not be able to stabilize the pelvis as they lift their leg to step forward, so the pelvis will tilt forward the non-weight bearing leg (Trendelenburg sign) which results in a waddle type of gait

Answer 13

myopathic gait

Question 14

Which gait is most commonly seen in muscular dystrophy?

Answer 14

myopathic gait

Question 15

Which gait is this?
-seen with rigidity and hypokinesia (also known as bradykinetic or hypokinetic gait) from basal ganglia disease
-posture is stooped forward
-gait initiation is slow and steps are small and shuffling
-patient will turn like a statue “en bloc”
-may have pill-rolling tremor in the hands and decreased facial expression

Answer 15

Parkinsonian gait

Question 16

Which gait is this?
-hyperkinetic gait seen in certain types of basal ganglia disorders like Huntington’s disease
-intrusion of irregular, jerky, involuntary movements in both the upper and lower extremities
-movements have a writhing, snake-like quality to them (athetosis)
-no loss of balance here

Answer 16

choreiform gait, also known as chorea

note: if patient has chorea + athetosis then this is called choreoathetosis, but is still under choreiform gait

Question 17

Which gait is this?
-patient’s gait is wide based/wide stance with truncal instability and irregular lurching steps which results in lateral veering and if severe, falling
-jerky movements to the side with a loss of balance/unsteadiness
-seen in midline cerebellar disease/damage from strokes, MS, ataxic cerebral palsy, or sensory ataxia

Answer 17

ataxic gait

Question 18

What is sensory ataxia?

Answer 18

loss of proprioception

Question 19

In which gait type would you see a foot drop also known as a steppage gait?

Answer 19

neuropathic gait

Question 20

In which gait type would you see a waddle?

Answer 20

myopathic gait