Hemiplegic gait describes the walking difficulty an individual may have after disease progression, an injury or a stroke. It describes an unsteady walk due to a partial paralysis. Diagnosis is based on an assessment. Patients walk in a straight line whilst a specialist observes their three phases of walking. Here are the phases:
- Stance phase - when the foot is on the ground bearing weight
- Swing phase - when the foot swings forward to step out
- Double support phase - when both feet are on the ground bearing the body‘s weight. Interestingly this only accounts for 25% of walking time.
Because individuals and the causes of hemiplegic gait differ, there are a number of ‘sub-gaits’ which better describe the impacts.
Antalgic gait: This is a limping gait that avoids pain. Many of us adopt this if we hurt our ankles or knees.
Ataxic gait: An uncoordinated walk where feet are thrown outwards with heel and toe tapping the ground in a two-point motion.
Double-step gait: Has a different timing or length between steps rather than a rhythmic stride.
Drag-to gait: This is when the feet are dragged instead of lifted.
Equine gait: This is when the hip joint is flexed in order to make a step.
Festinating gait: This gait is characterised by short fast steps mainly taken on tiptoe. The patient may bend forward with straight hips and knees.
Four-point gait: When using crutches the patient will move the opposite leg to the crutch.
Causes of Hemiplegic Gait?
It’s often seen in stroke victims or those with cerebral palsy but can also be the result of any nervous system damage, neurological disease or skeletal structure injury. Amputation patients are also affected.
The upper part of the leg may be adducted (pulled inwards to the body’s midline), rotated or in a flexed position.
The lower part of the leg may be twisted or rotated. The knee may be extended or the ankle may be ’plantar-flexed’ which means the toes are pointing downwards. There may be inversion problems with the ankle such as the sole of the foot facing inward.
New Study Shows Rhythmic Music Therapy improves walking in Hemiplegic gait patients
A recent study on patients with stroke or cerebral palsy indicated that music therapy, known as rhythmic auditory stimulation (RAS), may help hemiplegic gait.
Eighteen patients trained three times a week for thirty minutes a session. After four weeks results indicated that both flexed and straightened body motion was improved as well as an improvement in uneven gait patterns.
Stroke victims showed significant improvements. Those walking in their homes improved their pelvic tilt, whilst community walkers improved their swing and stance phases. Stroke patients in the sub-acute category showed more improvement compared to the chronic sufferers.
Previous studies have highlighted the importance of music therapy, but as hemiplegic gait has few rehabilitation options, it’s encouraging to see results like these.