Diplegic gait
A diplegic gait, commonly known as a scissoring gait, can be caused by a lesion in the central nervous system. This could mean a complete transection of the spinal cord or a stroke. Clinical findings are comparable to those in hemiplegic gait but are bilateral.
Spasticity is generally worse in the lower limbs than the upper limbs. The knees and hips are flexed and adducted, while the ankles are internally rotated and extended.
The knees are pushed together due to spasticity in the adductor muscles, which results in leg overlap when walking, a.k.a. scissoring. The person experiencing this circumducts both legs during the swing phase to fight this adduction.
The upper limb may have flexor posturing of the wrist and elbows with fingers and shoulders in adduction, known as the “low guard” or “mid-guard” position. They also generally lack the swinging movements present in a normal gait.
Clinical features which might be associated with this type of abnormal gait include:
-Reduced power
-Increased tone with clasp-knife spasticity
-Wasting and fasciculations (motor neuron disease)
-Hyperreflexia with or without clonus
-Upgoing planters
-Sensory deficit: If a diplegic gait is caused by spinal cord pathology, the “sensory level” is associated with the level of spinal cord pathology
One Response
I am surprised that your list of reasons for gait abnormalities did not include normal pressure hydrocephalus. I started involuntarily shuffling my feet and had diminished stride In my early seventies. When I took Anatomy and Physiology in college, the instructor told us that some people with brain injuries could not stride more than 12 inches when walking. In addition to stride changes, I found it increasingly difficult to organize and reason. I couldn’t put together a report for my work. A CT scan revealed a significantly enlarged third ventricle. I had an ETV performed by image-guided surgery to form a drainage path through scar tissue that blocked the flow of CNS in my third ventricle at OHSU in Portland. I got immediate relief and have no gait or mental confusion symptoms for the last 10 years.