Gait

Question 1

Name some pathological gaits

Answer 1

Ataxic (cerebellar)
Apraxic
Antalgic
Tendelenberg/Myopathic
Shuffling/Parkinsonian
Waddling
Hemiplegic
Stomping/sensory 
Scissoring (e.g cerebral palsy)

Question 2

Describe an ataxic gait

Answer 2

Most commonly seen in cerebellar disease
Clumsy, staggering movements with a wide-based gait.
Patients will not be able to walk from heel to toe or in a straight line.
The gait of acute alcohol intoxication will resemble the gait of cerebellar disease.

Question 3

Describe an apraxic gait

Answer 3

Found in patients with bilateral frontal lobe disease
It is characterised by an inability to initiate the process of walking, despite the power and coordination of the legs being normal when tested in the seated or lying position.
A broad-based gait with short stride, freezing, and falls.

Question 4

Describe an antalgic gait

Answer 4

Usually caused by limb pain
It is a limping gait where there is pain on weight bearing
Stance phase is significantly shortened relative to the swing phase to minimise loading and reduce pain.

Question 5

Describe a trendelenberg/myopathic gait

Answer 5

Caused by hip abductor weakness
(can be due to unilateral hip muscular dystrophy)
Weakness on one side, will lead to a drop in the pelvis on the contralateral side of the pelvis while walking (Trendelenburg sign)
If bilateral it becomes a waddling gait.

Question 6

Describe a shuffling/parkinsonian gait

Answer 6

Patient presents with bradykinesia, tremor, and rigidity.
Small, shuffling steps with flexed knees
Stooped with the head and neck forward
Lack of arm swing

Question 7

Describe a waddling gait

Answer 7

Due to the weakness of the proximal muscles of the pelvic girdle. (hip abductors and gluteals)
The patient uses circumduction to compensate for gluteal weakness.

Question 8

Describe a hemiplegic gait

Answer 8

Can be due to a cerebrovascular accident.
Patient has unilateral weakness on affected side, with leg in extension and foot plantarflexed.
During swing phase, affected limb circumducts to clear ground due to foot drop and extensor hypertonia in the lower limb.

Question 9

Describe a sensory/stomping gait

Answer 9

Loss of this propioreceptive input
The patient will slam the foot hard onto the ground in order to sense it
A high stepping gait.

Question 10

Describe a scissoring gait

Answer 10

Often due to cerebral palsy (spastic paraplegia and UMN lesions)
Excessive hip adduction in swing phase. As a result, the swing leg crosses in front of the stance leg.
Knees and thighs may cross/touch while walking
Ankles may be turned inwards while walking
Feet often make contact with the ground primarily at the ball of the foot, not the heel
Arms and hands may go outwards from the body to provide balance