This document discusses gait disorders and abnormal gaits caused by various neurological and musculoskeletal conditions. It describes reasons for abnormal gait including loss of symmetry from unilateral disorders, difficulty initiating gait seen in Parkinson's, and foot dragging seen in footdrop. The document also outlines tests of normal gait and characteristics of abnormal gaits associated with conditions such as hemiparesis, paraparesis, Parkinsonism, cerebellar dysfunction, chorea, dystonia, sensory deficits, muscular dystrophy, and lower motor neuron disorders.

1. Gait disorders
Gait- speed, smoothness,
symmetry, synchrony

2. Reasons for abnormal gait
 Loss of symmetry- unilateral neurological or
musculoskeletal disorders
 Difficulty initiating gait- Parkinson’s
 Dragging foot- footdrop
 Wide-based gait- cerebellar & B/L knee/hip disease
 Circumduction- foot moves in an arc-
pelvic muscle weakness & fixed knee joint
 Decreased arm swing- Parkinson’s, dementia,
paresis
 Deviation from path- motor control defect, alcohol

3. Testing gait
 When instructed-
 Quick onset
 Walk normally- symmetric, rhythmic, synchronised
 Hip & knee flex, ankle dorsiflexes,
foot clears the ground
 Turn instantly
 Stand erect with feet together,
with eyes open & closed- Romberg’
sign
 Walk on heels, toes, tandem

4. Abnormal gait
 Hemiparesis- affected arm adducted,
leg extended; circumduction of leg while
walking, with decreased arm movement
 Paraparesis- scissoring of legs
 Parkinsonism- flexed posture, masked facies;
resting tremor; slow initiation, decreased arm swing;
small, shuffling steps, with festination
 Cerebellar- wide-base, can’t do tandem walking,
with tendency to fall towards involved side

5. Abnormal gait
 Chorea- dancing gait, irregular steps,
can’t walk in straight line
 Dystonia- depends on site
 Sensory- wide-base, Romberg’s +ve;
steps vary in length, stamping gait
 Muscular dystrophy- winged scapulae,
waddling gait, Gower’s sign +ve
 LMN disorders- foot drop- high stepping gait

6. Abnormal gait
 Chorea- dancing gait, irregular steps,
can’t walk in straight line
 Dystonia- depends on site
 Sensory- wide-base, Romberg’s +ve;
steps vary in length, stamping gait
 Muscular dystrophy- winged scapulae,
waddling gait, Gower’s sign +ve
 LMN disorders- foot drop- high stepping gait