202 Part II PRACTICE
practitioner needs to be comfortable with the language and methods
CLASSIFICATION OF GAIT DISORDERS
STROKE
Table B1 A gait
classification based on the
level of the impairment, often
used by neurologists
used by a variety of professions, aiming to integrate biomechanical
principles into management wherever possible, but also with an
appreciation of medical and psychosocial models.
The approach used to classify gait disorders varies according to its pur-
pose. For example, physicians (especially neurologists) tend to focus on
the anatomical level of the lesion (Table B1). On the other hand, those
directly involved in rehabilitation (e.g. therapists and physiatrists) are
more interested in the biomechanical causes of the abnormalities
(Watelain et al 2003).
This book is aimed at understanding general principles useful in
analysing any gait disorder. Nevertheless, it is important to be aware of the
main pathologies and their typical characteristic clinical presentations.
In an average year, around 0.2% of the population has a stroke (Roth &
Harvey 1996). It is the most common of all neurological deficits and the
leading cause of gait impairment in rehabilitation facilities. Sometimes
called cerebrovascular accident (CVA), stroke is due to thromboem-
bolism (in 80% of cases) or haemorrhage (20%) of an artery supplying
High-level Cautious gait
Subcortical dysequilibrium
Frontal dysequilibrium
Isolated gait ignition failure
Frontal gait disorder
Psychogenic gait disorder
Mid-level Hemiplegic gait
Diplegic gait
Paraplegic gait
Cerebellar ataxic gait
Parkinsonian gait
Choreic gait
Dystonic gait
Low-level Peripheral musculoskeletal problems:
● arthritic gait
● antalgic gait
● myopathic gait
● peripheral neuropathic gait
Peripheral sensory problems:
● sensory ataxic gait
● vestibular ataxic gait
● visual ataxic gait