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Date posted: March 28, 2012

Dr. Krishnendu maity

Gait signifies posture of the patient during walking. 

It is classified as

  1. Due to diseases of bonesLimping Gait of Talipes equinovarous.
  2. Due to diseases of jointsLimping Gait of Tuberculosis of Knee & Hip joints; Waddling Gait of Bilateral Congenital Dislocation of the Hip.
  3. Due to diseases of musclesWaddling Gait of Myopathies.
  4. Due to diseases of nervous system
  • Ataxia – This is the gait of sensory ataxia and typically found in Polyneuritis & Tabes dorsalis. In Polyneuritis, the gait is High Stepping; and in Tabes dorsalis, it is Stumping.
  • Prosthetic Gait – This is due to walking with an artificial limb.
  • Reeling Gait – It is found in Cerebellar diseases & Alcoholics. The patient walks on a broad base and the ataxia is present, irrespective of whether the eyes are open or closed.
  • Spastic Gait.
  • Scissor Gait – Typically found in Paresis & Congenital Paraplegia.
  • Festinant / Shuffling Gait – In Parkinsonism, the gait consists of short shuffling movements with a posture of flexion and an inability to slop walking suddenly, if pushed from backward – as if the patient runs to catch his Centre of Gravity.
  • Functional / Hysterical Gait – All types of gait may be present in combination or there may be bizarre movements. These are characteristically found in Hysteria; and absent when there is no observer.

 Another classification is as follows

Unilateral defect

  1. Hemiplegic Gait / Circumduction Gait.
  2. High-stepping GaitParalysis of External Popliteal Nerve, Peripheral Neuritis affecting one side.
  3. Hysterical Gait
  • Forward – either Scrapping of inner border (Organic Hemiplegic scrapes outer border of foot) or Whole foot is dragged along the ground.
  • Side-gait – cannot move on paralyzed side (Organic Hemiplegic can move better towards the paralyzed side).
  1. Limping GaitPoliomyelitis.
  2. Painful GaitSciatica or other injuries or Joint affections.

Bilateral Defect

  1. Ataxic GaitTumour of Vermis & Foramen Magnum; Disseminated Sclerosis; Sub-acute combined degeneration of the Cord.
  2. Bizarre GaitHysteria. Patient walks in zigzag fashion with bent knees or trunk.
  3. High Stepping GaitPolyneuritis; Muscular dystrophy; Tabes dorsalis.
  4. Jaunty GaitChorea.
  5. Maché Petits PasAdvanced Cerebro-vascular diseases.
  6. Reeling / Tottering GaitSevere Vertigo; Diplopia; Alcohol intoxication; Cerebellar lesion.
  7. Scissor GaitCongenital Cerebral Diplegia in children.
  8. Shuffling / Festinant GaitParkinsonism; Cerebral Arteriosclerosis; Instability; Lack of confidence.
  9. Spastic Gait – (Spastic Paraplegia) Disseminated Sclerosis.
  10. Stamping GaitTabes dorsalis; Carcinomatous Neuropathy; Compressive lesion of Posterior Column.
  11. Vestibular Gait – Deviation to same side on walking forward and to the opposite side of the lesion when walking backward.
  12. Waddling / Duck-like GaitMuscular dystrophy; Dislocation of Hip-joint.

 Addition to Bœnninghausen’s characteristics & repertory by Dr. Cyrus maxwell boger [bbcr]

Note: – The existing rubric and medicines in BBCR for gait are presented here with black; and the new additions (medicines & rubrics) are presented by blue colour. The abbreviations and gradations of medicines are adopted, as done by Dr. C. M. Boger – i.e. CAPITAL – 5 marks; Bold – 4 marks; Italics – 3 marks; Roman – 2 marks; (Roman) – 1 mark.

In the BBCR, the following rubrics are presented for gait —–

1. Lower Extremities – Gait, anxious: Coff, Nat-m.

  •  Awkward: Kali-n, lach, mag-c, saba.

2. Lower Extremities – Gait, cocks: Helo, LACH, nux-v.

  •  Knock knee: Lathy, Pho.
  •  Limping: Bell, Caus, colo, dro, dul, kali-c, kali-io, lyc, nit-ac, sul, syph, tab.
  •  Shuffling: Arn, chin, colch, led, nux-v, Zin.
  •  Slouchy, dragging: Mygal, nux-v, rhus-t, tab.
  •  Spastic: Cup, gels, lathy, nux-v, ph-ac, pho, zin.
  •  Stooped: Arn, calc-p, Lathy, pho, Sul, terb.
  •  Stumbling: Agar, bell, calc, (caps), caus, colch, con, dro, (gels), hyo, ign, iod, ip,    Lach, lil-t, (mag-c), mag-p, nat-c, nat-m, nux-v, (op), pho, pho-ac, rut, saba, sil,   Verat, zin.
  • Tottering: Alum, arg-m, aur, BAR-C, caus, cocc, colch, con, nux-v, pho, pic-ac,  Plb, rhus-t.
  •  Tremulous: Cup, phys.
  • Uuncertain, unsteady: Agar, arg-n, arn, bar-c, bar-m, carb-s, caus, cocl, gels, kali-bro, lol-t, mygal, nat-c, nux-v, old, oxyt, ph-ac, pho, phys, sec-c, sil, stansul, zin.
  • Compare Walking 

3. Lower Extremities – Walking, backward: Canth, lach, mang-ac, oxyt, sil.

  • Difficult: Aur, cact, chin, mang-ac, old, oxyt, phys, sil, ter.
  • Falling easily: Caus, lyc, nat-c, nat-m, stra.
  • Foot shoots out or turns: Acon.
  • Gressus gallinaceus: Aur, ign, LACH, mag-p, Sil.
  • Gressus vaccinus: Iod, sec-c.
  • Heels do not touch ground: Lathy.
  • Infirm: Caus, kali-c, mag-c, mag-p, nat-c, ol-an, pho, sul.
  • Learning, slow in: Agar, bar-c, bell, calc-c, calc-p, Caus, merc, NAT-M, nux-v, sanic, sil, sul,
  • Weakness with:  Chin, par, stro.
  • Leg involuntarily thrown forward: Merc.
  • Outer side of foot, with: Cic.
  • Compare Gait

Sources:-

  • Boger, Dr. C. M. – Bœnninghausen’s Characteristic and Repertory.
  • Hutchison’s Clinical Methods (edited by Dr. Michael Swash).
  • Kent, Dr. J. T. – Repertory to Homœopathic Materia Medica.
  • Vakil, Dr. P. – A text Book of Homœopathic Therapeutics for Students and Practitioners (illustrated) (vol. I). 

Dr Krishnendu maityBHMS [Calcutta] MD (Hom. Repertory) [Pune]
Associate Professor & HOD I/c, Department of Practice of Medicine
Teaching Practice of Medicine, Materia Medica & Repertory
Lal Bahadur Shastri Homœopathic Medical College, Bhopal – 26 (MP)
Email: dr_krishnendu@yahoo.com

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