1. Cerebellar gait
The patient has a broad-based gait, reeling and lurching to one side.
2. Parkinsonian gait
The steps are small and shuffling, and the patient walks in haste (festinates). The entire body stoops forwards, knees bent, head hunched forward, and the feet must hurry to keep up with it as if trying to catch up with the centre of gravity. There is associated loss of arm swing and mask-like facies.
3. Hemiplegic gait
The gait is slow. spastic and shuffling. With each step the pelvis is tilted upwards on the involved side to aid in lifting the foot off the ground, and the entire affected limb is circumducted, rotated in a semicircle at the pelvis. The upper limb is flexed, adducted and does not swing, and the lower limb is extended.
4. Sensory ataxia
The feet stamp, the movement of the legs bearing no relation to the position of the legs in space since proprioception is impaired or absent. The patient has to look down at the ground to compensate for the loss of proprioception. The patient walks on a wide base; the feet are lifted too high off the ground and are brought down too vigorously.
5. High-stepping gait
This is usually unilateral and results from foot-drop. The patient has to lift the foot high in order to avoid dragging the forefoot.
It may be due to the following:
Lateral popliteal nerve palsy.
· Poliomyelitis.
· Charcot-Marie-Tooth disease.
· Lead or arsenic poisoning.
6. Scissor gait
This is seen in spastic paraplegia. The adductor spasm may be so severe as to lead to the legs crossing in front of one another. Short steps with the front of the feet clinging to the ground result in a wearing out of the toes of shoes.
7. Waddling gait
The legs are held wide apart and the patient shifts weight from one side to the other as he walks. Comment on the lumbar lordosis. It is seen in advanced pregnancy and proximal weakness (Cushing's syndrome, osteomalacia, thyrotoxicosis, poly-myositis, diabetes, hereditary muscular dystrophies).
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