During an investigation on pasen with impaired walking, required a thorough examination and assessment stage by stage .
It should be noted :
• symmetry and smoothness of movement
• stride length and width
• pace
• parts of the body, head, shoulders, arms, waist, hip, knee, heel and toe
• movement with related of the eyes, head and body
• noise generated from the road
• patient's job .
There are some common causes of pathological gait :
• structural abnormalities ( shape and length of the bone )
• joints and soft tissue disorders ( arthritis , contractures , clavus )
• pregnancy , ascites and abdominal tumors
• neurological disorders ( neuromuscular ), central nervous system disorders, peripheral nerve and muscle disorders ( cerebral infarction, tumor, hydrocephalus, cerebellar atrophy, myelopathy, sensory disorders, neuropathy, muscular dystrophy and others)
Examination walking ( gait ) is done with eyes open or closed .
Patients are asked to walk :
• towards the front, rear, sides and surrounds seat
• on the fingers and on the heel
• follow a line on the floor
• above the wooden bar
• tandem
• sideways with one leg crossing the other leg
• forward and turned quickly
• forward and backward repeatedly ( 6-8 steps ) with closed eyes
• slow then fast then run
• take the stairs
Pasen also asked to stand up quickly from sitting, standing, walking and stopped suddenly, and turned quickly on command (Fournier test) .
Various gait abnormalities which are essential in the diagnosis of neurological diseases .
