Abnormal Gaits

MAIN ABNORMAL GAITS
Hemiplegic Gait
Diplegic Gait
Neuropathic Gait
Myopathic Gait
Parkinsonian Gait
Choreiform Gait
Ataxic Gait




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Diplegic Gait

Demonstration
The
patient has spasticity in the lower extremities greater than the upper
extremities. The hips and knees are flexed and adducted with the ankles
extended and internally rotated. When the patient walks both lower
extremities are circumducted and the upper extremities are held in a mid
or low guard position. This type of gait is usually seen with bilateral
periventricular lesions. The legs are more affected than the arms
because the corticospinal tract axons that are going to the legs are
closest to the ventricles


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The Gait
in this video this man has an UMN lesion affecting
both lower extremities. He has spasticity and weakness of the legs and
uses a walker to steady himself. There is bilateral circumduction of the
lower extremities



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Myopathic Gait


Demonstration
With muscular diseases, the proximal pelvic girdle
muscles are usually the most weak. Because of this the patient will not
be able to stabilize the pelvis as they lift their leg to step forward,
so the pelvis will tilt toward the non-weight bearing leg which results
in a waddle type of gait



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The Gait
In this video This young boy has pelvic girdle
weakness, which produces a waddling type of gait. Note the lumbar
hyperlordosis with the shoulders thrust backwards and the abdomen being
protuberant. This posture places the center of gravity behind the hips
so the patient doesn't fall forward because of weak back and hip
extensors




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Neuropathic Gait


Demonstration
This type of gait is most often seen in peripheral nerve disease where
the distal lower extremity is most affected. Because the foot
dorsiflexors are weak, the patient has a high stepping gait in an
attempt to avoid dragging the toe on the ground.


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The Gait
In this video The girl has weakness of the distal right lower extremity
so she can't dorsiflex her foot. In order to walk she has to lift her
right leg higher then the left to clear the foot and avoid dragging her
toes on the ground

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Parkinsonian Gait


Demonstration
This type of gait is seen with rigidity and hypokinesia from basal
ganglia disease. The patient's posture is stooped forward. Gait
initiation is slow and steps are small and shuffling; turning is en bloc
like a statue


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The Gait
in the video The
man's gait is bradykinetic and his steps are smaller then usual. There
is also the pill-rolling tremor in his hands. He turns en bloc and there
is decreased facial expression

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Demonstration
The patient's gait is wide-based with truncal instability and irregular
lurching steps which results in lateral veering and if severe, falling.
This type of gait is seen in midline cerebellar disease. It can also be
seen with severe lose of proprioception (sensory ataxia


video of demonstration [ندعوك للتسجيل في المنتدى أو التعريف بنفسك لمعاينة هذا الرابط]


The Gait

In this video The woman's gait is wide-based and unsteady. She has to
use a walker or hold on to someone in order to maintain her balance
(note how hard she has to work with the hand that she's holding on with
in order to maintain her balance). Her ataxia is even more apparent when
she tries to turn
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