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Gait abnormality is a deviation from normal walking ().Watching a patient walk is an important part of the neurological examination. Normal gait requires that many systems, including strength, sensation and coordination, function in an integrated fashion.
Spastic hemiplegia is a neuromuscular condition of spasticity that results in the muscles on one side of the body being in a constant state of contraction. It is the "one-sided version" of spastic diplegia. It falls under the mobility impairment umbrella of cerebral palsy. About 20–30% of people with cerebral palsy have spastic hemiplegia. [1]
Spastic cerebral palsy is caused by malformation of or damage to the parts of the brain that control movement. [12] What exactly makes some children susceptible to such brain damage is often unknown but it is believed that cerebral palsy may be the result of causal pathways, or chains of events that cause or increase the likelihood of brain injury. [13]
Hemiplegia, in its most severe form, is the complete paralysis of one entire side of the body. Either hemiparesis or hemiplegia can result from a variety of medical causes, including congenital conditions, trauma, tumors, traumatic brain injury and stroke.
Gait deviations are nominally referred to as any variation of standard human gait, typically manifesting as a coping mechanism in response to an anatomical impairment. Lower-limb amputees are unable to maintain the characteristic walking patterns of an able-bodied individual due to the removal of some portion of the impaired leg.
Romberg's test is not a test of cerebellar function, as it is commonly misconstrued. Patients with severe cerebellar ataxia will generally be unable to balance even with their eyes open; [ 6 ] therefore, the test cannot proceed beyond the first step and no patient with cerebellar ataxia can correctly be described as Romberg's positive.
[73] [74] Orthopaedic surgery is widely used to correct fixed deformities and improve the functional capacity and gait pattern of children with CP. Dynamic deformities such as ankle equinus and hip adduction deformity leading to subluxation are usually managed conservatively with exercises; serial casting and botulinum toxin type A injections.
A unilateral spastic gait presents with the affected leg held in extension and plantar flexion. The arm on the same side is often flexed. The individual circumducts the affected leg as they swing it during walking. [1] A bilateral spastic gait may appear stiff-legged or scissoring.