Abnormalities of Gait
- associated with unilateral upper motor neuron disease
- one arm is flexed, close to the side and immobile
- the leg is circled stiffly outward and forward, circumducted
- often the toe is dragged when walking
- associated with bilateral spastic paresis of the legs
- Each leg is advanced slowly
- Thighs tend to cross forward on each other at each step
- The steps are short
- The patient looks as if he were walking through water.
- Associated with foot drop, usually secondary to lower motor neuron disease
- The feet are lifted high, with knees flexed and then brought down with a slap on the floor.
- The patient looks as if he were walking upstairs.
- Associated with loss of position sense in the legs
- The gait is unsteady and wide-based, the feet are far apart.
- The feet are lifted high and brought down with a slap
- The patient watches the ground to guide his steps
- He cannot stand steadily with feet together when his eyes are closed, Romberg test is positive.
- Associated with disease of the cerebellum or associated tracts
- The gait is staggering, unsteady and wide-based with exaggerated difficulty on the turns
- The patient cannot stand steadily with feet together, whether eyes closed or open.
- Associated with the basal ganglia defects of Parkinson’s disease
- The posture is stooped
- The hips and knees are slightly flexed
- Steps are short and often shuffling
- Arm swings are decreased and the patient turns around stiffly – “all in one piece”.
Bates, Barbara. 1974. A Guide to Physical Examination. J.B. Lippincott Company, Toronto.