Gait patterns and their localisation

What it is

Gait is all about pattern recognition. Each gait is named for what causes it, so the walk itself gives the answer.

How it presents

• Hemiparetic gait: arm adducted, leg extended, stiff and circumducting.
• Spastic paraparesis: slow, stiff, jerky, with scissoring and adduction at the knees and dragging of the toes.
• Cerebellar: wide based and unsteady, can't walk a straight line.
• Parkinson's: slow and stiff with small and shuffling steps, neck and trunk and limbs semi flexed, and decreased or no arm swing.
• Sensory ataxic: high stepping gait with stomping feet.
• Neuropathic: high stepping with foot drop.
• Myopathic: waddling or rolling.

The hemiplegic patient is drawn with the arm bent and the hand spastic or floppy, often of little use, one side completely or almost normal, and the walk on tiptoe or on the outside of the foot on the affected side. The Parkinson's figure adds stooped posture, masked face, back rigidity, forward tilt of the trunk, flexed elbows and wrists, reduced arm swing, hand tremor, tremors in the legs, slightly flexed hip and knees, and a shuffling, short stepped gait. The sensory ataxic walk is also named trampling.