Gait disorders

Question 1

Hemiplegic gait

Answer 1

• Unilateral weakness
• Arm flexed and internally rotated
• Leg drags

Common cause = stroke

Question 2

Diplegic gait

Answer 2

Both sides involved

Spasticity in both legs

Narrow base gait, legs drag and toes scrape

Hip adductors are tight so scissor legs occurs

Question 3

Neuropathic gait

Answer 3

High stepping gait

Seen unilaterally in patients with foot drop, DM

Seen bilaterally in patients with MND/ CMT/ DM

Toes point and high step - loss of dorsiflexion causing the toes to scrape the ground while walking

Question 4

Myopathic gait

Answer 4

AKA Trendelenburg’s

Something wrong with muscles causing hip to drop

• Weakness in one side of hip girdle muscles leads to a drop in the contralateral side
• Superior gluteal nerve damage: this innervates gluteus medius and minimus
• Weakness on both sides causes bilateral drop and a waddling gait seen in muscular dystrophy

Question 5

Choreiform/ hyperkinetic gait

Answer 5

Seen in basal ganglia disorders e.g. Huntington’s

• Irrregular, jerky movements in all extremities, muscles twitching all over the place
• Imagine ants in their clothes

Question 6

Ataxic/ cerebellar gait

Answer 6

Most commonly seen in cerebellar disease

• Clumsy, staggering movements with a wide/ broad-based gait
• While standing patient will sway
• Unable to walk heel-to-toe in straight line
• Unable to maintain sitting posture

Imagine a drunk person

Question 7

Parkinsonian gait

Answer 7

• Rigidity, bradykinesia
• Stooped, head and neck forward
• Flexion at knees
• ‘Mache a petit pas’ - walk of little steps
• Difficulty initiating steps

Question 8

Sensory gait

Answer 8

Loss of proprioceptive input telling the person where their foot is so they slam their foot on the ground so they can sense it

AKA stomping gait

Caused by disorders that affect the dorsal columns e.g. B12 deficiency/ tabes dorsalis