HIGHER-LEVEL GAIT DISORDERS
FRONTAL GAIT DISORDER
REDUCED CADENCE
EN-BLOCK WIDE BASE TURN
TROUBLE USING WALKING AID
ABNORMAL POSTURE DURING STANDING
DIFFICULTY IN INITIATING STEP
SLOW PACE WALKING WITH PRESERVED SWAY
FREEZING WITHOUT FESTINATION
WIDE BASE WITH DIFFICULTY IN TURNING
BACKWARD POSTURAL INSTABILITY
TENDENCY TO RETROPULSION (SITTING/ STANDING/ WALKING)
NORMAL PRESSURE HYDROCEPHALUS
FOOT OUT TURNED
REDUCED VELOCITY
INCREASED/ DECREASED CADENCE
REDUCED STRIDE LENGTH
NORMAL AGEING
INCREASED STEP WIDTH BY 40%
CADENCE IS THE SAME AS IN YOUNG
REDUCED GAIT VELOCITY
REDUCED STEP LENGTH
CAUTIOUS WALK OF AGING:
AFTER FALL 50% OF THE ELDERLY DEVELOP A FEAR OF FALLING
LIKE MOVING ON SLIPPERY SURFACE
KINETIC PARAMETERS:
INCREASING BASE/ INCREASED DOUBLE SUPPORT TIME/ REDUCED SINGLE SUPPORT TIME/ REDUCED STRIDE
ATTITUDE:
FLEXION OF TRUNK/ REDUCED ARM SWING/ ARM ABDUCTED
PHOBIA OF UNIPEDAL STANCE (CAN'T TAKE FIRST STEP)
PARKINSONISM
FREEZING OF GAIT (FOG)
ON FOG/ OFF FOG
PSEUDO ON FOG
HIGHER LEVODOPA THRESHOLD FOR IMPROVING FOG
SILLY WALK
BIZARRE WALK
BIPHASIC DYSKINESIA
BALLISTIC STEREOTYPIC KICKING OR STAMPING
CRAB GAIT
COMPENSATORY SIDEWAY STRIDE
CAN BE SEEN IN FOG
FOOT DYSTONIA
PARKIN MUTATIONS
EARLY SPONTANEOUS MANIFESTATION OF PD
LATE MANIFESTATION AS OFF DYSTONIA
PENGUIN/ CHAPLIN GAIT
FEET EXTERNAL ROTATION
KNEE HYPEREXTENSION
ETIOLOGY:
NPH
PARKINSON'S DISEASE
SPASTICITY
CHOREA
HUNTINGTON DIEASE
CHOREO-ACANTHOCYTOSIS
STUTTER STEP GAIT
REDUCED STRIDE AND CADENCE
HESITATION IN HEAL OFF (TERMINAL STANCE)
HYPEREXTENSION OF KNEE (MID STANCE)
CAN RESEMBLE FOG/ HESITATION
RUBBER MAN GAIT
CHOREO-ACANTHOCYTOSIS
SUDDEN VIOLENT TRUNCAL MOVEMENTS
TARDIVE GAIT
SHORT STEPS ON TOES FOLLOWED BY LONG STRIDES
FUNCTIONAL GAIT
1. INCONSISTENCY
2. ASTASIA ABASIA/ UNABLE TO MAINTAIN UPRIGHT POSTURE (ASTASIA) AND WALK (ABASIA)
3. HUFF AND PUFF SIGN
4. STRIATAL TOE: NOT FLEXED BY HYPEREXTION. OF OTHER TOES
5. STRIATAL TOE: RESIST FLEXION
6. PLANTER FLEXION OF FEET ON WALKING
7. HELICOPOD GAIT: SWING FEET IN HALF CIRCLE
8. GAIT IMPROVES ON CONCENTRATION ON PHONE
9. CAUTIOUS GAIT (CAN BE ORGANIC IN SENSORY ATAXIA/ ELDERLY WITH FALLS)
10. EXCESSIVE SLOWNESS (CAN BE SEEN IN PYRAMIDAL GAIT)
11. UNECONOMICAL POSITION
-
FLEXION OF SPINE/ KNEE/ HIP
-
NARROW BASE
-
CONTROL OF IMBALANCE AT THE LIMIT
12. SUDDEN KNEE BUCKING (SEEN IN THAP 1 DYSTONIA)
13. TIGHT ROPE WALKING (ARM ABDUCTED AND EXTENDED): ALSO SEEN IN CAUTIOUS GAIT OF ELDERLY
14. HESITATION AND PAUSES
15. PSYCHOGENIC ROMBERG
-
SWAY BUILDS AFTER LATENCY
-
IMPROVES WITH DISTRACTION
-
RETROPULSION WITH EYE CLOSURE
-
LARGE AMPLITUDE OSCILLATIONS
DD:
-
FUNCTIONAL GAIT
-
CAUTIOUS GAIT OF ELDERLY
-
FRONTAL GAIT DISORDERS (SUPPLEMENTARY MOTOR AREA/ SUBCORTICAL FRONTAL WHITE MATTER INVOLVEMENT)
DYSTONIA
PEACOCK GAIT
HIP AND KNEE FLEXION
PLANTER FLEXION IN SWING PHASE
CRAB GAIT
COMPENSATORY SIDE WAY STRIDE
DYSTONIA/ RARELY IN FOG
COCK GAIT
HYPERMANGANESEMIA/ PKAN
TRUNCK EXTENDED
ARMS FLEXED
TOE WALKING
ALSO SEEN IN PKAN
BACKWARD LEANING GAIT
NIEMANN PICK TYPE C
PLA2G6
SCA3
LEANING BACKWARD DURING GAIT
TIC
MOTOR TICS
EPISODIC/ BRIEF/ STEREOTYPE
INTERFERING WITH NORMAL GAIT
ATAXIA
ATAXIC GAIT
BROAD BASE GAIT
VARIABLE STEP LENGTH
INCREASED DOUBLE SUPPORT TIME
INCREASED DOUBLE SUPPORT VARIABILITY
INCREASED LATERAL SWAY IS COMPENSATED BY:
CAUTIOUS WALK/ STOOPING
STEADING STANCE BY BENDING HIP
BEAR/ QUADRUPEDAL GAIT
ATP8A2/ TUBB2B/ DYAF07
UNER TAN SYNDROME
ATAXIA/ CEREBELLAR ATROPHY
SPASTICITY
HEMIPARETIC GAIT
GAIT SLOW/ WIDE BASE/ ASYMMETRICAL
CIRCUMDUCTION
SLIGHT HIP FLEX
KNEE CAN'T FULLY EXTEND AT END STANCE PHASE
FOOT INVERTED AND PLANTER FLEXED
REDUCED STANCE PHASE ON PARETIC SIDE
PENGUIN/ CHAPLIN GAIT
FEET EXTERNAL ROTATION
KNEE HYPEREXTENSION
SCISSORING GAIT
ADDUCTOR SPASTICITY
SPASTIC GAIT WORSENS ON FAST WALK
PERIPHERAL NEUROPATHY/ MYOPATHY
WADDLING
PROXIMAL MUSCLE WEAKNESS
HIP ON SWINGING SIDE DROPS
INCREASED LUMBAR LORDOSIS
HIGH STEPPAGE GAIT
DISTAL MUSCLES WEAKNESS