Nuero Exam: Post-Stroke Hemiplegic Gait

One of the main characteristic features of post-stroke gait, is the hemiparetic or hemiplegic gait. It is important to note, that in acute settings, patients with hemispheric stroke, who present with unilateral weakness of upper and/or lower extremities usually have flaccid paralysis. It will take a few weeks for this gait to develop.

As seen in the video, one leg is held stiffly and in order for the affected foot to clear the floor patients normally tend to circumduct the affected leg from the hip joint.  Due to weak dorsiflexors on the affected side the foot also scrapes the ground. The arm on the same side does not swing and is flexed at the elbow.  The most common cause of such a gait in adults is stroke, but there is no value to test this in acute settings, because as mentioned above this gait mainly develops after a few weeks of the onset of stroke.

 

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