Gait Problems

Question 1

Hemiparetic

Answer 1

unilateral UMN injury (eg. hemispheric stroke)

affected side: arm by side, drags foot in semicircle

Question 2

Diplegic

Answer 2

bilateral periventricular lesions (eg. cerebral palsy)
narrow base, dragging both legs and scraping toes
also scissoring gait: legs cross midline due to tightness in hips

Question 3

Neuropathic (Steppage, Equine)

Answer 3

unilateral: peroneal nerve palsy, L5 radiculopathy
bilateral: ALS, CMT, uncontrolled diabetes
Pt has foot drop NO DORSIFLEXION so raises leg v high to stop foot dragging

Question 4

Myopathic (Waddling)

Answer 4

myopathies such as Muscular Dystrophy

dropping of pelvis on contralateral side to weakness (Trendelenburg sign) or both sides

Question 5

Bradykinetic (Parkinsonian)

Answer 5

Parkinson’s and parkisonisms (eg. drug side effects)
stooped with head and neck forward, flexion at knees, rigidity, bradykinesia
accelerations, difficulty initiating, marche a petits pas

Question 6

Choreiform (Hyperkinetic)

Answer 6

basal ganglia disorders (incl. Huntington’s)

irregular, jerky, involuntary movements in extremities

Question 7

Ataxic

Answer 7

cerebellar disease (also acute EtOH intox resembles it)
wide based, clumsy, staggering, no heel to toe or straight line
titubation: sways when standing still

Question 8

Sensory

Answer 8

dorsal column disorders (eg B12, tabes dorsalis) also uncontrolled diabetes)
slams foot down in order to sense it, worse in dark, may lift leg v high