Gait Deviations Associated with Abnormal
Muscle Tone
A variety of abnormal gait patterns are associated with abnormal
muscle tone (spasticity, rigidity, hypotonicity, or abnormal
motor control) or muscle weakness.Steppage gait occurs when there is weakness
or paralysis of the dorsiflexor musculature, such as in persons
with peroneal palsy or peripheral neuropathy, demands exaggerated
hip and knee flexion of the proximal joints to accomplish
swing clearance.Although orthosis use can successfully control
abnormal motion in the sagittal plane (e.g., in steppage
gait), orthoses are less effective in controlling the abnormal
transverse, rotational, or coronal limb placement problems
observed in scissoring or crouched gait pattern.Scissors gait describes a
pattern of poor control in limb advancement or tracking of the
swing leg often characterized by the crossing, or scissoring
(hip adduction, flexion and medial rotation), of the lower limbs.In ataxic gait there is a failure of coordination or irregularity
of muscular action of the limb segments commonly caused
by cerebellar dysfunction.It is most often observed in patients with spastic or paretic
pathological conditions such as hemiplegia, spastic diplegia,
and cerebral palsy.In crouch gait exaggerated knee and hip flexion occurs
throughout the gait cycle.Crouch gait is often seen in combination
with a toe-walking stance in children and adults
with spastic diplegic cerebral palsy.It has been attributed to a
combination of overactivity of the hamstrings and weakness
of calf muscles.Ataxia often becomes accentuated
when the eyes are closed or vision is impaired or distracted.It is most easily observed in late MSw.