Expert Clinical Perspectives: Patterns and assessment of spastic hemiplegic gait-Article

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Hemiparetic gait disorders are common in stroke survivors, and a circumductory gait is often considered typical. However, in clinical practice, a wide range of abnormal gait patterns can be observed, depending on the severity of weakness and spasticity. Muscle strength is the key determinant of gait disorders in hemiparetic stroke survivors. Spasticity and the involuntary activation of spastic muscles can alter the posture of the joints, leading to abnormal gait patterns. A stepwise visual gait analysis approach is proposed to identify the primary underlying causes. The assessment begins with examining pelvic and hip joint movement, followed by an assessment of ankle and foot complex abnormalities, and finally an examination of knee joint abnormalities. Muscle strength and spasticity of all relevant joints should be assessed prior to the gait analysis. Lidocaine nerve blocks can be a useful diagnostic tool. Recognizing different patterns and identifying primary causes are critical for developing interventions to improve gait function in stroke survivors. Hemiparetic gait disorders are associated with a high risk of falls, so understanding the patterns and causes of gait abnormalities is important for implementing appropriate interventions to improve walking safety and prevent falls in stroke survivors.

Keywords

hemiparetic gait disorders

stroke survivors

circumductory gait

abnormal gait patterns

muscle strength

spasticity

joint posture

visual gait analysis

primary underlying causes

lidocaine nerve blocks