Gait Disturbances Flashcards
What is the Normal Gait Cycle?
- Heel-Strike
- Foot flat
- Mid-stance
- Heel-off
- Toe-off
- Swing
What is a Hemiplegic Gait?
- Spastic flexion of the upper limb
- Extension of the lower limb
- Due to extension the leg is elongated meaning patients have to circumduct their leg to prevent their foot dragging on the ground
What are the causes of Hemiplegic Gait?
- Stroke
- Space-occupying lesion
- Trauma
- MS
What is a Diplegic Gait?
- Knees are forced together due to the spasticity in the adductor muscles resulting in leg overlap when walking causing scissoring
- The patient circumducts both legs
What are the causes of Diplegic Gait?
- Prolapsed Intervertebral Disc
- Spinal Spondylosis
- Cerebral Palsy
- Multiple Sclerosis
- Bilateral Brain Infarcts
- Motor Neuron Disease
What is a Parkinsonian Gait?
- Slow initiation
- Reduced step length stride - Shuffling gait
- Arm swing reduced
- Stooped posture
- Resting tremor
- Impaired balance leading to hesitancy on turning
What are the causes of Parkinsonian Gait?
- Parkinsonian disorders
- Idiopathic Parkinson’s Disease
- Vascular Parkinson’s disease
- Dementia with Lewy Body
- Parkinson’s plus syndrome
- Drug- induced parkonism
What is an Ataxic Gait?
- A Broad Based gait
- Staggering, slow and unsteady gait
- Struggling with the turning manoeuvre
What are the causes of a Cerebellar Ataxic Gait?
Cerebellar Ataxia:
- Cerebellar Stroke
- Space occupying lesion
- MS
- Alcoholism
- B12 deficiency
- Drugs (pheytoin, carbamazepine, barbiturates, lithium)
- Genetic Disease
What are the causes of a Sensory Ataxia?
- Peripheral Neuropathy (DM)
What are the causes of a Vestibular Ataxia?
- Labyrinthitis
- Meniere’s Disease
- Acoustic Neuroma
What are the Clinical Features associated with a Cerebellar Ataxia?
- Nystagmus
- Ataxic Dysarthria
- Dysmetria
- Intention Tremor
- Dysdiadokokinesia
What are the Clinical Features associated with Sensory Ataxia?
- Positive Romberg’s Sign
- Impaired Proprioception
- Impaired Vibration Sensation
- Absence of other cerebella signs
What are the Clinical Features associated with Vestibular Ataxia?
- Vertigo
- Nausea
- Vomiting
What is a Neuropathic Gait?
- High-steppage Gait
- Weakness of the muscles in the distal limb as a result of damage to the peripheral nerves providing motor innervation
- Foot Drop
- To prevent toes from dragging on the floor, the knee and hip flex excessively creating a high-steppage gait
What are the causes of Neuropathic Gait?
- Isolated common peroneal nerve palsy
- L5 radiculopathy
- Generalised polyneuropathy (diabetic neuropathy, MND, Charcot-Marie Tooth disease)
What is a Myopathic Gait?
- A myopathic gait occurs due to the weakness of the hip abductors resulting in a waddling appearance
- Hip abductor weakness results in an inability to stabilize the pelvis
- The pelvis tilts downwards towards the unsupported side
- Circumducting the leg
What are the causes of Myopathic Gait?
- Hyperthyroidism
- Hypothyroidism
- Cushing’s Syndrome
- Acromegaly
- Polymyalgia Rheumatica
- Polymyositis
- Dermatomyositis
-Duchenne’s Muscular Dystrophy
- Becker’s Muscular Dystrophy
- Myotonic Dystrophy
What is a Choreiform Gait?
- A hyperkinetic Gait with involuntary movements
- Oro- Facial dyskinesia ( grimacing/ lip-smacking)
- Choreic movements ( writhing/ semi-purposeful movements)
What are the causes of Choreiform Gait?
- Huntington’s disease
- Sydenham’s Chorea
- Cerebral palsy
- Wilson’s disease
- Dopaminergic Medications
What is an Antalgic Gait?
- Abnormal gait which develops from pain
- Limping appearance is seen
What are the causes of Antalgic Gait?
- OA
- Inflammatory joint disease
- Lower limb fracture
- Sciatica
