Gait disorder

1. GAIT DISORDERS Supervised by: Dr Tan Li Ping

2. EXAM: STEPS Make sure the patient’s legs are clearly visible Ask the patient to walk normally, turn around and walk back. Observe: i ) Posture ii) Balance iii) Position & swinging of the arms iv) Movement of the legs Perform tandem gait (heel-to-toe) EXPOSURE OBSERVE PERFORM

3. ROOMBERG’S TEST  ask patient to stand with the heels together, first with eyes open ,then with eyes closed Unsteadiness

4. EXAM: OTHER 5.Other examinations: a)Walk on toes -S1 lesion b)Walk on heels -high stepping gait(foot drop) c)Test for proximal myopathy (squat and then stand up) -waddling gait d)Lie down and imagine pedaling a bicycle - apraxic gait 6. End examination by looking for additional signs. Example; -Parkinsonism signs - Cerebellar signs

5. 1. HEMIPLEGIC GAIT Thus the foot is swung in a lateral arc and pelvis is elevated on that side to avoid the affected foot from scraping the floor. Characteristics of hemiplegic gait

6. 2. SCISSORS GAIT Knee appear to be stuck together Feet stuck to the floor Spastic Paraperesis Characteristics of scissors gait

7. 3. CEREBELLAR GAIT Characteristics of cerebellar gait

8. 4. PARKISONIAN GAIT Characteristics of Parkisonian gait

9. 5. WADDLING GAIT Characteristics of waddling gait

10. 6. HIGH STEPPING GAIT Characteristics of foot drop

11. 7. STAMPING GAIT

12. 8. APRAXIC GAIT Impaired ability to plan and execute sequential movements due bilateral frontal lobe disease

13. 9. PSYCHOGENIC/ HYSTERICAL GAIT Gait does not conform to any one of typical gait disorders A.k.a Astasia - abasia ( inabililty to stand or walk in a normal manner) Characteristics: -Normal coordination of leg movements in bed or while sitting -Unable to stand or walk without assistance -If distracted, stationary balance is sometimes maintained and several steps are taken normally, followed by a dramatic demonstration of imbalance with a lunge toward the examiner's arms or a nearby bed .

14. IMAGING MRI BRAIN SPINAL X-RAY SPINAL MRI EMG(Electromyography) CXR/CT THORAX

15. BLOOD INVESTIGATION FBC & PBF ESR Syphilis serology Serum B12 U & E Prostate Specific Antigen Serum Creatine phosphokinase

16. OTHER INVESTIGATIONS Lumbar puncture Muscle biopsy

17. MBBS IIIA FINALS THANK YOU & GOOD LUCK group 10