The way in which an individual walks. Gait may be aﬀected by inherited disorders; by illness – especially neurological disorders; by injury; or by drug and alcohol abuse. Children, as a rule, begin to walk between the ages of 12 and 18 months, having learned to stand before the end of the ﬁrst year. If a normal-sized child shows no ability to make movements by this time, the possibility of mental retardation must be borne in mind, and if the power of walking is not gained by the time the child is a year and a half old, RICKETS, CEREBRAL PALSY, or a malformation of the hip-joint must be excluded.
In hemiplegia, or PARALYSIS down one side of the body following a STROKE, the person drags the paralysed leg.
Steppage gait occurs in certain cases of alcoholic NEURITIS, tertiary SYPHILIS (tabes) and other conditions where the muscles that raise the foot are weak so that the toes droop. The person bends the knee and lifts the foot high, so that the toes may clear obstacles on the ground. (See DROP-FOOT.)
In LOCOMOTOR ATAXIA or tabes dorsalis, the sensations derived from the lower limbs are blunted, and consequently the movements of the legs are uncertain and the heels planted upon the ground with unnecessary force. When the person tries to turn or stands with the eyes shut, he or she may fall over. When they walk, they feel for the ground with a stick or keep their eyes constantly ﬁxed upon it.
In spastic paralysis the limbs are moved with jerks. The foot ﬁrst of all clings to the ground and then leaves it with a spasmodic movement, being raised much higher than is necessary.
In PARKINSONISM the movements are tremulous, and as the person takes very short steps, he or she has the peculiarity of appearing constantly to fall forwards, or to be chasing themselves.
In CHOREA the walk is bizarre and jerky, the aﬀected child often seeming to leave one leg a step behind, and then, with a screwing movement on the other heel, go on again.
Psychologically based idiosyncracies of gait are usually of a striking nature, quite diﬀerent from those occuring in any neurological conditions. They tend to draw attention to the patient, and are worse when he or she is observed.