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4. ANTALGIC GAIT (Painful Gait) | Definition s fh gait adopted by the person to minimize pain while walking . Characteristics : e Short stance phase on affected (painful) leg. e Decreased weight bearing on affected side. . Longer Swing phase on affected leg. e Body leans toward the painful side. during stance on unaffected leg. e Overall gait is slow and cautious. Sketch : leans e-- towards painful side R =P we = z > x z | ae "i 7 : , 4. Initial 2. Stance Phase 3: Swing Phase 4. Next Initial Contact (Short stance on (Longer Swing Contact (Unaffected leg affected leg & on affected (Cycle repeats ) contacts first) decreased weight leg) bearing) Causes : @ Fracture (Qs femur, tibia, etc.) @ Osteoarthritis (knee, hip, ankle) ® Muscle injury [ Strain @ Sprain (ankle, knee) © © Rheumatoid arthritis Any painful condition of lower limb or foot which causes pain during weight bearing. The main purpose of antalgic gait is to avoid pain and protect the affected Limb. 2. TRENDELENBURG GAIT Definition A gait in which the pelvis drops on the opposite side of the weak hip abductors during the stance phase. Characteristics : e Weakness or paralysis of hip abductor muscles (mainly gluteus medius & minimus) on one side. e During stance phase on the affected side, the pelvis drops down on the opposite (contralateral) side. e Body leans towards the stance leg to keep the center of gravity over the base of Support. e Gait appears lurching . Sketch : Pelvis drops on opposite side ' \ 7 \ if \ 7 v v Normal (SC TIT pelvic Y ‘ level 1. Right Stance 2. Left Swing 3. Left Stance 4. Right Swing (Normal pelvic (When right side (When left side (Pelvis returns level) is stance, pelvis is stance, pelvis to normal level) drops on left side) drops on right side) Causes : ® Superior gluteal nerve injury Hip dislocation Congenital dislocation of hip Post-surgical weakness of gluteus medius / minimus 2) @ @ Muscle diseases (e.g., muscular dystrophy, poliomyelitis) © © Any condition causing weakness i paralysis of hip abductors It is alse called “Lurching gait” Seen due to weak hip abductors. : 4.. SPASTIC DIPLEGIC / SCISSOR GAIT Definition : A gait in which both lower limbs are stiff and adducted so that the legs cross each other like scissors while walking . Characteristics : e Increased muscle tone (spasticity) in both lower limbs. * Adduction of hips, flexion of hips and knees. ° Leas cress each other during the swing phase. e Gait is slow and unsteady. e Seen more in children with cerebral palsy. Sketch : Legs cross each other (scissor action) 4. Initial Contact 2. Stance Phase 3. Swing Phase 4. Stance Phase 5. Next Swing (Both legs (Weight on (Legs cross (Weight on Phase adducted ) one leg) each other) other leg) (Legs cross again) Causes : Cerebral palsy (spastic diplegia) Spasticity due to upper motor neuron (UMN) lesion Spinal cord disorders (e-g., spine. bifida.) Perinatal brain injury y birth asphyxia Traumatic brain injury in children OQOSGLO Any condition causing increased tone and adduction of beth lower limbs Note : This gait is also called “Scissor gait” because the legs cross each other like the blades of a scissor. 5. STEPPAGE GAIT (NEUROPATHIC GAIT) Definition : A gait in which the person lifts the affected leg higher than normal and steps down with an exaggerated high the toes due to foot drop - Characteristics : © Caused by weakness or paralysis of the ankle dorsiflexors . © To clear the foot from the ground, the person excessively flexes the hip and knee. e Foot drops during swing phase. © The person may land on the heel with a slap or may circumduct the leq slightly . ¢ Gait is slow and tiring. Sketch ketch : Starts with heel contact 4. Initial Contact 2. Stance Phase 3. Swing Phase 4. Foot Drop 5. Next Initial Foot drops (dorsiflexor weakness) Lands on v heel with Pes (Heel contact (Weight on (Leg lifted high (Foot hangs Contact of affected leg) affected leg) to clear the down during (Heel _ strike ground ) swing) with slap) Causes : @ Common peroneal nerve injury (e.g., fibular neck injury) @ Peripheral neuropathy (e-g., diabetic neuropathy ) ® Ls radiculopathy ® Anterior horn cell disease (eg., poliomyelitis ) © Any condition causing weakness / paralysis of ankle dorsiflexors (tibialis anterior, extensor hallucis longus, extensor digitorum longus) Note : This gait is also called “Foot drop gait” because the front part of the foot drops during swing phase. 7, ATAXIC GAIT Definition ; A gait in which the person walks unsteadily with a wide base of support and shows lack of coordination . Characteristics : © Wide based gait. ° Unsteady , staggering or reeling . @ Lack of coordination . Difficulty in maintaining balance. e May sway from side to side. © Gait is i regular and inco-ordinated . © Often worsens in dark. Sketch : Ter (c » D) | i> > > => , ») , | | »)} « i * ! / a a — pipes ee Pd | 4. Wide base eh Swaying oy Unsteady, 4. Trreqular oy, Difficulty in of Support from side reeling or steps maintaining to side staggering balance Causes : ® Cerebellar lesion (tumor, stroke, degeneration) F ® Alcohol intoxication (chronic alcoholism) . (0) Multiple sclerosis . ® Vitamin B, deficiency (subacute combined degeneration) . © Labyrinthine disorders (inner ear problem). © Drug toxicity (e.9., phenytoin, sedatives). @ Any condition affecting cerebellum or proprioception . Note : Ataxic gait is due to cerebellar dysfunction leading to loss of co-ordination and balance . 8. SENSORY ATAXIC GAIT Definition : A gait due to loss of position and vibration sense from posterior column lesion, The person walks unsteadily and stamps the feet heavily on the ground to get Sensory feedback . Characteristics : e Lifts the feet high and brings them down with a stamp . e Worse in dark (no visual compensation) . e Needs to look at the ground while walking . © Broad based and unsteady . ° History of loss of position and vibration sense. ° Rombera’s test positive . Sketch : Stamps Heavily foot on stamps for — — ground = Sensory i od feedback Ss Ly ) } / us ae Pa ahe 1. Standing 2. Lifting of leg 3. Stamping 4. Lifting other leg 5. Repeat (Unsteady (Raises foot (Brings foot (Again lifts (Continues in standing ) high) down heavily ) foot high) Same manner) Causes : ® Vitamin Bo deficiency (subacute combined degeneration) . @® Posterior column lesion (e-g., tabes dorsalis) . ® Peripheral neuropathy . ® Diabetes mellitus . © Alcoholism . © Any condition causing loss of position and vibration sense. Note : Stomping of feet is done to obtain additional Sensory input from the ground as position and vibration sense are lost. 40. PARAPARETIC (SPASTIC) GAIT Definition : A gait in which the person walks with stiff, weak and spastic lower limbs due to upper motor neuron lesion involvin pyramidal tracts . Characteristics : e legs are stiff and adducted. ° Scissoring of legs. © Toe walking (plantar flexion) . @ Small, slow steps. © Difficult to initiate walking . ©@ Balance is poor. e Uses support (stick / wall) if needed. e Frequently seen in spastic paraparesis. Sketch : Noa 4 1. Standing 2. Lifting of leg 3. Leg crosses 4. Toe contact 5. Other leg ® i ; (Stiff legs (Slight over the other (Plantar advances adducted.) flexion) (Seissoring) flexion) (Repeat) Causes : Upper motor neuron lesion (pyramidal tract) . Cerebral palsy (spastic diplegia / paraplegia) . Spinal cord lesion (e.g., spastic paraparesis, myelopathy) . Multiple sclerosis. Hereditary spastic paraplegia. ®O®GOO Any condition causing increased tone of lower limbs. Note : Paraparetic (spastic ) gait is due to increased muscle tone (spasticity ) causing stiffness, adduction, and scissoring of lower limbs. 4 - 11. HEMIPLEGIC (UMN) GAIT Definition : A gait in which the person walks with one side of the body affected due to upper motor neuron lesion causing weakness and spasticity . Characteristics : e Involves only one side of the body. e Arm on affected side is flexed at elbow, adducted and held close to the body. © Hand may be clenched. © Leg on affected side is stiff (spasticity). © Circumduction of the affected leg. © Foot may drag or there is no heel contact. e Decreased balance and coordination. e Seen in stroke, brain tumour, cerebral palsy, etc. Sketch : => > > => > LY x e of % iF 1, Standing 2. Cireumduction 3. Leg susings 4, Fook contact 5. Other leg 6, Repeat (Arm flexed, of affocted leg ferdard (Gften lon) eduarces adducted) (Leg lifted out (Knee extended) forefoot or flat) te sida) Causes : Stroke (CVA). Brain tumour. Multiple sclerosis. Cerebral palsy. Spinal cord injury (above lumbar enlargement). Any upper motor neuron lesion. ®©OOO86 Note : Hemiplegic gait is due to weakness, spasticity and loss of selective motor control on one side of the body due to upper motor neuron lesion. 
