Gait is one of the complex motor activities comprising the nervous system functions responsible for locomotion and balance. Gait disorders are a common manifestation of diseases of the nervous system, especially in old age.
As the causes of gait disorders are manifold, their classifications also vary.
One of them distinguishes three anatomical and pathophysiological levels of gait disorders: low, middle and highest.
Low-level gait disorders result from damage to peripheral musculoskeletal components. Examples are gait disorders occurring with inflammation and other joint diseases, in neuromuscular diseases. Middle level gait disorders are caused by damage to deep brain structures, such as the thalamus and basal nuclei, and the brainstem and cerebellum. Gait disorders at the highest level include cases with cortical brain damage.
Depending on the site of damage, several clinical forms can be distinguished:
- waddling gait- occurs in cases of damage to the fibular nerve, the feet are dropped, so the patient lifts the lower limbs high
- parkinson's gait- characteristic of Parkinson's disease, it is a hypokinetic, slowed gait. Patients walk with small steps , posture is bent forward. Sometimes the patient is unable to make a movement and has to step backwards. In addition, postural instability may occur including retropulsion or a tendency to fall backwards, lateropulsion or falling sideways, propulsion or a tendency to fall forwards.
- scissor gait - in cerebral palsy, crossing of the lower limbs is characteristic
- cerebellar gait - typical of cerebellar damage, it is a wobbly gait, on a wide base. It is reminiscent of a drunken or "sailor" gait.
- choreic gait or chorea gait - the proper gait activity is superimposed on involuntary movements, grimaces, twisting of the trunk, limbs, "dancing" movements
- dystonic gait- during an attempt to walk there is a forced bending of the sole of the foot and a twisting of the pelvis
- waddling gait - sideways wobbling is characteristic, typical of conditions such as muscular dystrophy, congenital hip dislocation
- atactic gait - is unsteady, steps are uneven, long with excessive bending of the knees and strong thumping of the feet, the patient constantly looks under the feet
- paraparetic, spastic or paraspastic gait - the patient gives the impression of being tied down, the limbs are rigidly placed with the ground shaking
- paraparetic gait, flaccid - occurs in flaccid paresis of the lower limbs, gait is slow, limbs break down with a tendency to fall
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hemiparetic, cutting gait - occurs in hemiparesis, the upper limb is usually bent and the lower limb is straightened, during walking the limb makes cutting movements