Examination Posture And Gait

CO-ORDINATION

Ask patient to repeatedly run the heel from the opposite knee down the shin to the big toe. Look for ATAXIA (inco-ordination). Ask patient to repeatedly tap the floor with the foot. Note any DYSDIADOCHOKINESIA (difficulty with rapidly alternating movement).

Romberg's test

Note any excessive postural swaying or loss of balance

Ask patient to stand with the heels together, first with the eyes open, then with the eyes closed.

Note any excessive postural swaying or loss of balance

Present when eyes open or closed

Present only when eyes are closed ('positive' Romberg's)

= cerebellar deficit (cerebellar ataxia)

= proprioceptive deficit (sensory ataxia)

GAIT

Note:

- Abnormal leg movements (e.g. excessively high step)

- Instability (gait ataxia)

- Associated postural movements (e.g. pelvic swinging) Abnormal

If normal, repeat with tandem walking, i.e. heel to toe. This will exaggerate any instability.

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