Gait Flashcards
Hemiplegic gait
Unilateral weakness on affected side
Arm flexed, adducted and internally rotated
Drags affected leg in semicircle (circumduction) due to weakness of distal muscles (foot drop) and extensor hypertonia in lower limb
Most commonly seen following stroke
Diplegic gait
Spasticity on both sides, worse in lower extermities than upper
Abnormally narrow base, dragging both legs and scraping the toes
Extreme tightness of hip adductors which can cause legs to cross midline - scissors gait
Seen in bilateral periventricular lesions e.g. cerebral palsy
Neuropathic gait
Seen in patients with foot drop - attempt to lift leg high enough during walking so that foot doesn’t drag on floor
Unilateral - peroneal nerve palsy and L5 radiculopathy
Bilateral - ALS, CMT and peripheral neuropathies
Myopathic gait
Dropping of pelvis on contralateral side to weak gluteus medius
Bilateral - dropping of pelvis on both sides during walking leading to waddling
Seen in myopathies such as musuclar dystrophy
Choreiform gait
Seen in basal ganglia disorders e.g. Huntington’s
Irregular, jerky, involuntary movements in all extremities
Walking may accentuate their baseline movement disorder
Ataxic gait
Most commonly seen in cerebellar disease
Clumsy, staggering movements with a wide-based gait
Titubation (swagger back and forth and from side to side)
Not be able to walk heel-toe or in straight line
Similar to acute alcohol intoxication
Parkinsonian gait
Rigidity and bradykinesia Stooped and flexion at knees Marche a petit pas Difficulty initiating steps Festination and hesitancy
Sensory gait
Sensory ataxic gait when loss of proprioceptive input
Slam foot hard on floor
Worse when patients cannot see their feet e.g. in dark
Disorders of dorsal columns e.g. B12 deficiency or in peripheral nerve disease e.g. uncontrolled diabetes
When severe can resemble cerebellar ataxic gait
