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:
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Patients with cerebellar ataxia require a wide gait for stability.
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Footdrop causes a steppage gait (lifting the leg higher than normal to avoid catching the foot on surface irregularities).
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Pelvic muscle weakness causes waddling.
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Spastic leg causes scissoring and circumduction.
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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.
