Abnormal gait

Introduction to gait abnormalities Gait abnormalities can be caused by movement or sensory disturbances, and their characteristics are related to the lesion site. Can be seen in many nervous system or other system diseases, some typical abnormal gait, has a suggestive meaning for certain diseases, can make a diagnosis by looking at the diagnosis, for some atypical gait, it must be carefully examined, through analysis and synthesis It also helps the diagnosis. Clinical classification of gait abnormalities should be combined with the cause. basic knowledge Probability ratio: Susceptible people: no specific people Mode of infection: non-infectious Complications: cerebral arteriosclerosis cerebral arteriosclerosis pediatric brain tumors polyneuritis

Abnormal cause of gait

Causes

The common causes of abnormal gait are as follows:

1. Cortical spinal cord lesions can lead to spastic hemiplegic gait and spastic paraplegia.

2. Bilateral frontal lobe lesions can lead to a lost gait.

3. Frontal (cortical or white matter) lesions can lead to small gait (marcheà petit pas).

4. Extrapyramidal lesions can lead to panic gait and distortion, odd asynchronous state.

5. Cerebellar lesions lead to ataxia gait.

6. Alcohol or barbiturate poisoning leads to drunken gait.

7. Others have sensory disturbances leading to ataxia gait; due to the tibialis anterior muscle, gastrocnemius muscle weakness leads to cross-threshold gait; trunk and pelvic muscle weakness leads to myopathy gait; palpitations caused by psychogenic diseases.

Gait abnormality prevention

There is no effective preventive measure for this disease. Early detection and early diagnosis are the key to the prevention and treatment of this disease.

Gait abnormalities Complications cerebral arteriosclerosis cerebral arteriosclerosis pediatric brain tumor polyneuritis

Foot gait: common in patients with polyneuritis, cervical spondylosis, and spinal cord spasm;

Panic gait: more common in cerebral arteriosclerosis, brain tumors, old head trauma, etc.;

Lush gait: mainly seen in the cerebellum or vestibular disease

Cross gait: more common in patients with cerebral palsy, paraplegia and so on.

Gait abnormal symptoms Common symptoms Gait instability Cerebellar ataxia gait gait abnormal gaze closed eye standing can not gluteus numbness gait sphincter dysfunction sensory ataxia misuse gait panic gait

Corticospinal tract lesion

(1) hemiplegic gait: unilateral lesions, the upper limbs of the diseased side are usually flexed, adducted, the waist is inclined to the healthy side, the lower limbs are straight, external rotation, outward swinging (compensation of the hip, knee flexor) And the squat flexor muscles caused by the weakness of the foot), walking in a circled gait; mild patients only show lower limb towing gait, seen in the sequela of stroke.

(2) spastic paraplegia: bilateral severe paralytic muscle tension, patients with lower extremity tonic adduction, with compensatory trunk movement, walking effort, scissor-like gait, common in children with cerebral palsy, spinal cord trauma, etc. .

2. Disappeared gait caused by bilateral frontal lobe lesions, common in hydrocephalus or progressive dementia, patients without limb weakness or ataxia, but can not stand or walk on their own, showing gait instability, uncertainty and At small steps, the feet seem to stick to the ground, with obvious hesitation (freezing) and dumping.

3. Small gait (marcheà petit pas) is seen in the frontal lobe (cortex or white matter) lesions, showing small steps, dragging, slow start or turn, gait instability, easy to be misdiagnosed as Parkinson's disease gait, but small gait is The base is wide, the upper limbs have swinging motion, with cognitive impairment, frontal lobe release symptoms, pseudobulbar palsy, pyramidal tract dysfunction, and sphincter dysfunction. It can be identified, but it should be noted that patients with frontotemporal dementia can also be combined with Parkinson's disease. disease.

4. Extrapyramidal lesions

(1) Panic gait: seen in late Parkinson's disease, the torso bends forward when walking, the hips, knees and ankles are bent, the start is slow, the difficulty of stopping and the difficulty of turning, the small gait rubbing the ground, showing a rushing, Easy to fall, the upper limbs coordinated swing disappeared.

(2) Dystonia is characterized by an abnormal posture of the limb or trunk, which can affect the movement or cause distortion, and the odd-asynchronous state.

5. Cerebellar ataxia gait

(1) cerebellar sacral lesions lead to trunk ataxia, irregular gait, clumsy, unstable and wide base, difficult to turn, can not go straight, seen in the midbrain tumor and spinal cerebellar ataxia.

(2) cerebellar hemisphere lesions lead to gait instability or coarse jumping action (dance-like gait), shaking left and right, tilting to the disease side, visual correction can be partially corrected, often accompanied by poor limb resolution, seen in cerebellar lesions and multiple sclerosis Wait.

6. Drunk gait is seen in alcohol or barbiturate poisoning, gait squatting, shaking and tilting back and forth, seemingly want to lose balance and fall, can not be corrected by vision, and the difference between cerebellar ataxia gait is that drunken person can The narrow basal plane walks a short distance and maintains balance, while the cerebellar ataxia is always a broad base gait.

7. Sensory ataxia gait is seen in Friedreich ataxia, subacute combined degeneration of the spinal cord, multiple sclerosis, spinal cord spasm and sensory neuropathy, etc. The patient can't stand with closed eyes, shake and fall easily, and the vision can be partially compensated when blinking. (Romberg sign); the lower limbs move heavy when walking, lift the foot, heavy, and increase when walking or closing the eyes at night.

8. Cross-threshold gait is seen in common peroneal nerve palsy, sacral muscular atrophy and progressive spinal muscular atrophy. Due to the weakness of the tibialis anterior muscle, the gastrocnemius muscle leads to the foot, and the limb is raised when walking, such as across the threshold.

9. Myopathy gait is seen in progressive muscular dystrophy, etc. Due to the weakness of the trunk and pelvic girdle leading to lordosis, the hips swing side to side as they walk, like a duck step.

10. Hysteric gait can show grotesque gait, although the lower limb muscle strength is good, but can not support the weight, swinging in all directions and seems to fall, squatting while walking, but rarely fall injured, seen in the heart disease.

Gait abnormality check

The necessary selective laboratory tests include: blood routine, blood electrolytes, blood sugar, and urea nitrogen.

The necessary optional auxiliary inspection items include:

1. Bottom of the skull, CT and MRI examinations.

2. Cerebrospinal fluid examination.

3. Chest, ECG, ultrasound.

Gait abnormality diagnosis

Through comprehensive analysis, symptom diagnosis based on the characteristics of the asynchronous state, and further consideration of the cause diagnosis, gait needs to be observed:

1. The length of the stride.

2. Walking speed.

3. Bilateral symmetry.

4. Flexibility of movement.

5. Coordinated movement of the upper limbs (too little or too much).

6. The position of the head and shoulders.

7. Coordination of the trunk (forward or backward, left or right).

8. Activity of the pelvis (front, back, left, right).

9. The state of the heel of the heel and the shift of the center of gravity during walking.

10. The length of the footing period (the period of the heel strikes the ground) and the length of the foot (the period when the toes are off the ground), the mutual ratio and the relationship with the trunk movement.

The gait of each normal person is affected by various factors such as height, weight, self-child habits (such as outer eight-step, inner eight-step), personality, walking speed, mental state, fatigue, and excitement.

The material in this site is intended to be of general informational use and is not intended to constitute medical advice, probable diagnosis, or recommended treatments.