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Abnormal Gait

From Mediwikis

For Gait examination, see GALS.

Antalgic

Patient avoids putting weight on the affected side, showing a rapid, heavy step with a shortened stance phase.

This indicates pain with weight bearing

Causes

Spastic

Asymmetric, stiff circumduction of the legs. Scuffing of the foot along the ground

Causes

Extrapyramidal

Flexed posture, shuffling, Bradykinesia, postural instability

Causes

Apraxic

Short steps, with broad-based unsteady gait.

Causes

  • Hydrocephalus
  • Multi-infarct states

Ataxic

Broad-based gait, cannot walk heel-to-toe. Often stumbles or falls.

Sensory (Proprioceptive) vs Cerebellar:

  • Sensory- Romberg's test shows the patient is more unsteady with their eyes closed than open.

Causes

Myopathic

'Waddle' gait due to hip girdle muscle weakness. Exaggerated circumduction. Cannot climb steps.

Causes

  • Pregnancy
  • Congenital hip dysplasia
  • Muscular Dystrophy

High Stepping/ Foot drop

Cannot dorsiflex the foot- in order to avoid tripping over one's own feet, the patient has to take a high step.

Psychogenic

Bizarre, fluctuating gait, not conforming to any known patterns. There may be inability to stand, but normal examination on the bed.