Gait Disorders | Medibuddy
21st November 2023

Gait Disorders

The following table is adapted from the paper ‘Gait and its Assessment in Psychiatry’ by Sanders and Gillig (2010) and describes the disorders in gait commonly encountered in psychiatry. I have simplified this table to indicate how the gait is commonly described for exam purposes.

Gait Description Associations
Antalgic  In lay terms  – A limp.

It presents as a shortened stance phase relative to the swing.

Orthopaedic injury (acute or prolonged).
Ataxic  Wide based, irregular, unsteady gait.

Difficulty walking toe to heel (tandem gait).

Cerebellar disease – Including strokes.

Alcohol related states  – Acute intoxication; Wernicke’s.

Circumducted It is seen in hemiparesis, whereby the leg is swung out and around. Hemiparesis (e.g. secondary to stroke).
High-steppage The leg is lifted higher than expected during the swing phase in order to prevent the foot from hitting the ground.

The foot appears floppy.

Also known as neuropathic or equine gait

Foot drop.

Multiple sclerosis.

Guillain-Barre.

Magnetic The feet appear stuck to the ground. Normal pressure hydrocephalus.
Parkinsonian Reduced arm swing, stooped posture, hesitation, large turning radius and festination (short shuffling steps). Parkinson’s disease.

Parkinsonism (including drug induced).

Sensory Ataxia  Due to loss of proprioception, the foot will slam into the ground in order for the patient to be able to feel it.

Also known as ‘stomping gait’.

Peripheral neuropathy.

Pernicious anaemia.

Friedreich’s ataxia.

Multiple sclerosis.

Spastic Stiffness due to increased muscle tone almost presents as a kicking motion on the swing phase. Demyelination (such as Multiple Sclerosis).
Scissoring  The knees and thighs cross over one another whilst walking due to increased tone of the hip adductors. Cerebral palsy.

Multiple sclerosis.

Spinal cord tumour or trauma.

Waddling Also known as a myopathic gait.

It has a broad base.

Weakness in the pelvic girdle.

Proximal myopathy.

Congenital hip dysplasia.

References

  • World Health Organisation (WHO) (2019/2021) International Classification of Diseases, Eleventh Revision (ICD-11). Available online at: https://icd.who.int/browse11. [Accessed February 2023]
  • Ford, R.A. (1989) ‘The psychopathology of echophenomena’. Psychological Medicine. 19(3):627-635.
  • Casey, P. and Kelly, B. (eds) (2019) Fish’s clinical psychopathology: Signs and symptoms in psychiatry. Fourth edition. Cambridge: Cambridge University Press.
  • Kaufmann C., Agalawatta N., and Malhi G.S. (2018) ‘Catatonia: Stereotypies, mannerisms and perseverations’. Australian & New Zealand Journal of Psychiatry. 52(4):391-393.
  • American Psychological Association (2023). APA Dictionary of Psychology. Available online at: https://dictionary.apa.org [Accessed February 2023]
  • Wijemanne S., and Jankovic J. (2015). ‘Movement disorders in catatonia’. Journal of Neurology, Neurosurgery & Psychiatry 86:825-832.
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  • Rybakowski J.K., Vansteelandt K., Remlinger-Molenda A., et al (2014). ‘Extrapyramidal symptoms during treatment of first schizophrenia episode: results from EUFEST’. European Neuropsychopharmacology. 24:1500–5
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  • Deuschl, G., Köster, B., Lücking, C.H. and Scheidt, C. (1998). ‘Diagnostic and pathophysiological aspects of psychogenic tremors’. Movement Disorders. 13: 294-302.
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  • Gordon, N. (2008). ‘Sydenham’s Chorea, and its complications affecting the nervous system’. Brain and Development. 31:11-14
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  • Kojovic M., Cordivari C., and Bhatia K. (2011). ‘Myoclonic disorders: a practical approach for diagnosis and treatment’. Therapeutic Advances in Neurological Disorders. 4(1):47-62.
  • Sanders R.D., and Gillig P.M. ‘Gait and its assessment in psychiatry’. Psychiatry. 7(7):38-43.
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