Gait short Flashcards
What should you never forget?
Ask about pain
What would you look for in general inspection?
Legs: WANG
- W-asting and fasciculations
- A-bnormal movements
- N-eurocutaneous stigmata
- G-rowth arrest
- P-osturing
Back
- spinal surgery scars
- scoliosis
Most important initial aspect to determine in gait exam?
Can they walk unaided or not
What to look for on walking in the gait exam?
a. SYMMETRIC vs ASYMMETRIC
b. Circumduction (often with arm flexed and foot drop)
- hemiparesis
c. Paraparetic (scissor gait)
- CP if no hip tendon release
d. Wide + staggering based gait with CB pathway dysfunction
e. Waddling/slapping gait
- proximal myopathies (i.e hip down on opposite side and side affected they will lurch
towards)
f. High stepping gait (distal weakness)
- Peripheral neuropathy
g. Posterior column loss (clumsy slap down of feet on broad base)
h. Antalgic gait
i. Unrecognised pattern: then describe
- Stance: steady or not
- Start and stop
- Steps (heel, toe lift off)
- Stride length
- Swing of arms
- Spin around
What are you looking for in a heel-toe walk?
for CB problems (can also be weakness, sensory problems)
What are you looking for on toe-walking
Plantar flexion (S1): unable to do DMD, CP: able to do well (spasm with hip adductor tightened)
What are you looking for on heel-walking?
Dorsiflexion (L5)
DMD, CP and others (anterior horn cell, peripheral neuropathy): unable to do
Why do we ask patients to walk on the outside of their heel (Fog test)?
bring out hemiplegia
Other than walk, heel-toe, toe-walk, heel-walk, walk on outside of heel –> what else on their feet should you get the patient to do?
Run, stand on each foot
What are you looking for in posture?
weak limb and hip girdle with DMD
What does a positive romberg sign indicate?
dorsal column loss (proprioception/light tough) if eyes closed, if eyes open then cerebellar problems
Final three things to look for on exam?
Squatting, Gower’s sign, Leg Length discrepency
