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How to Assess Gait, Stance, and Coordination

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Normal gait, stance, and coordination require integrity of the motor, vestibular, cerebellar, and proprioceptive pathways (see also Movement and Cerebellar Disorders ). A lesion in any of the pathways causes characteristic deficits:

  • Patients with cerebellar ataxia require a wide gait for stability.

  • Footdrop causes a steppage gait (lifting the leg higher than normal to avoid catching the foot on surface irregularities).

  • Pelvic muscle weakness causes waddling.

  • Spastic leg causes scissoring and circumduction.

  • Patients with impaired proprioception must constantly observe placement of their feet to avoid tripping or falling.

Coordination can be tested with finger-to-nose or knee-to-shin maneuvers, which help detect ataxic movements.

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