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Understanding Dementia

Balance and Gait

This is an excerpt from the book Understanding Dementia, which is meant to be a practical manual for primary care physicians and other health care professionals. Chapter 6 deals with the neurological examination, which includes an examination of gait (i.e. how someone walks).


 


A crucial (and often neglected) part of the neurologic exam is the observation of gait. Common gait disorders associated with dementia are the hemiplegic gait, parkinsonian gait, ataxic gait and apraxic gait. The characteristics of a hemiplegic gait are well- known (circumduction at the hip, dragging of the affected foot, and lack of movement at the knee). Parkinsonian and ataxic gaits are also familiar to most primary care practitioners. The former, in its most characteristic guise, is accompanied by a stooped posture, loss of arm swing, shuffling, small steps, and festination - an ataxic gait is characterized by imbalance, and usually a broad couching stance in compensation. An apraxic gait is present when the previously learned motor activity (gait) can not be performed despite normal power and coordination of the legs. Typically the patient can stand, but has difficulty initiating gait, is very unsteady, takes small irregular steps, and their feet appear frozen to the floor. Detailed cuing (e.g. "life your right leg, now bend the knee, now put it forward.") often is helpful. This gait is consistent with both vascular disease and normal pressure hydrocephalus .
Taken from Understanding Dementia: A Primer of Diagnosis and Management
Kenneth Rockwood & Chris MacKnight, 2001
Chapter 6, pp 108-109

 

See Also:
About Dementia > Types of Dementia > Creutzfeldt-Jakob Disease
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Last updated April 16, 2014
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