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Hemiplegic
Gait Demonstration
The patient has unilateral weakness and spasticity with the upper extremity
held in flexion and the lower extremity in extension. The foot is in extension
so the leg is "too long" therefore, the patient will have to circumduct
or swing the leg around to step forward. This type of gait is seen with
a UMN lesion. |
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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. |
ii
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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. |
ii
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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. |
ii
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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. |
ii
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Choreiform
Gait Demonstration
This is a hyperkinetic gait seen with certain types of basal ganglia disorders.
There is intrusion of irregular, jerky, involuntary movements in both the
upper and lower extremities. |
ii
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Ataxic
Gait 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) |
ii
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Hemiplegic
Gait
This girl has a right hemiparesis. Note how she holds her right upper extremity
flexed at the elbow and the hand with the thumb tucked under the closed
fingers (this is "cortical fisting"). There is circumduction of the right
lower extremity. |
ii
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Diplegic
Gait
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. |
ii
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Neuropathic
Gait
This 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.
|
ii
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Myopathic
Gait
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. |
ii
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Parkinsonian
Gait
This 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. |
ii
Video
Courtesy of Alejandro Stern, Stern Foundation
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Choreiform
Gait
Note the involuntary, irregular, jerky movements of this woman's body and
extremities, especially on the right side. There are also choreiform movements
of the face. A lot of her movements have a writhing, snake-like quality
to them, which could be called choreoathetoisis. |
ii
Video
Courtesy of Alejandro Stern, Stern Foundation
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Ataxic
Gait
This 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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