Types of Abnormal Gait (Abnormal Character)
The types of abnormal gait (abnormal character) that may be
encountered are the following:
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Parkinsonian
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Marche a petits pas
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High steppage
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Scissor
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Ataxic
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Stamping
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Spastic
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Hemiplegic
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Waddling
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Gait apraxia
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Painful
Parkinsonian
In Parkinsonism the patient is bent forwards and walks with
short, shuffling steps. There is no arm swing.
Marche a petits pas
In marche a petits pas the patient walks with short
steps but the stance is upright and there is marked arm swing. The steps are
rapid and tapping. It occurs in diffuse cerebrovascular disease.
High Steppage
High steppage gait occurs due to foot drop where
dorsiflexion of the foot cannot occur. The knee is flexed and raised to allow
the foot to clear the ground. It occurs in L4, 5 root lesions,
common peroneal lesions, peripheral neuropathy. Occasionally it may be due to
lesions in the motor cortex.
Scissor Gait
In a scissor gait, the legs cross each other as they move
forwards. The toes are pointed inwards. It is seen in paraparesis due to
cerebral palsy, multiple sclerosis, cord compression.
Ataxic Gait
In an ataxic gait the patient walks as if they are drunk,
veering to the side of the lesion if the lesion is unilateral. Ataxia occurs
in cerebellar lesions such as phenytoin toxicity, alcohol toxicity, multiple
sclerosis, cerebrovascular disease, tumour.
Stamping Gait
In a stamping gait the patient stamps the feet on the
ground. It is seen in sensory loss in peripheral neuropathy, subacute combined
degeneration of the cord, tabes dorsalis.
Spastic Gait
In bilateral upper motor neurone lesions, both legs are
spastic and cannot be lifted off the ground. The patient walks with stiff
lower limbs. Hardly any flexion occurs at the knees.
Hemiplegic Gait
In hemiplegia, there is unilateral spasticity with flexor
hypertonia in the upper limbs and extensor hypertonia in the lower limbs. The
arm is held in flexion and the lower limb is extended, with extension at the
knee and ankle. The patient has to tilt the body to the opposite side and move
the lower limb in a semicircle in order to propel it forward. It is seen in
stroke.
Waddling Gait
In a waddling gait there is marked rotation of the pelvis
and shoulders whilst walking. It is seen in proximal myopathy, bilateral
congenital dislocation of the hips.
Gait Apraxia
In gait apraxia, the gait is abnormal as if the patient has
forgotten how to walk. It occurs in frontal lobe lesions such as normal
pressure hydrocephalus, cerebrovascular disease.
Painful Gait
A painful (antalgic) gait occurs in arthritis, trauma. The
painful limb buckles each time it bears weight so that the impact is
cushioned. The good limb hurries through to minimise the duration that the
painful limb has to bear weight.
