Gait disturbances can be a result of abnormalities in the coordination (ataxia), strength of voluntary movements (weakness or paresis) or lameness. We will assess for the presence or absence of those 3 potential abnormalities in all four limbs.

Ataxia: 

Ataxia = uncoordinated gait. There are 3 types of ataxia:

• • Proprioceptive (spinal, sensory) ataxia: limbs crossing over and clumsiness due to loss of the sense of limb and body position as a consequence of a lesion affecting the ascending proprioceptive pathways. Frequently associated to spinal cord lesions.
  • Vestibular ataxia: loss of balance and orientation of head, eyes, trunk, and limbs due to abnormalities in the vestibular system. Usually presents with head tilt and falling, leaning or rolling towards while walking.
  •  Cerebellar ataxia: inability to regulate the range and rate of movement. Hypermetric gait (longer protraction phase of gait with exaggerated and longer steps), particularly in the thoracic limbs, loss of balance and, frequently, intention tremors. Due to cerebellar lesions.

Paresis: 

Paresis is weakness or inability to generate movement voluntarily, so decreased (paresis) or absent (paralysis, -plegia) motor function.

Lameness:

Lameness mostly presents with a short stride on the affected limb. Usually associated with orthopedic disease although neurological origin is possible (“nerve root signature”).

Another possible abnormality in the gait is CIRCLING.

Posture

The posture of the body should be also evaluated. These are some of the common posture abnormalities:

1. Head: head tilt, head turn, head-body turn (pleurothotonus), low head carriage, head pressing
2. Trunk: kyphosis, lordosis, scoliosis
3. Limbs: spasticity, wide-base standing, decerebrate rigidity, decerebellate rigidity, Schiff-Sherrington posture…