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Underlying Defect Sensory Ataxia

Associated with loss of position sense in the legs, as from polyneuropathy or posterior column damage

Description The gait is unsteady and wide based (with feet wide apart). These patients throw their feet forward and outward and bring them down, first on the heels and then on the toes, with a double tapping sound. They watch the ground for guidance while walking. With eyes closed, they cannot stand steadily with feet together (a positive Romberg sign) and the staggering gait worsens.

Cerebellar Ataxia

Associated with disease of the cerebellum or associated tracts

The gait is staggering, unsteady, and wide based, with exaggerated difficulty on the turns. These patients cannot stand steadily with feet together, whether their eyes are open or closed.

Parkinsonian Gait

Associated with the basal ganglia defects of Parkinson's disease

Gait of Older Age

The aging process

The posture is stooped, with head and neck forward and hips and knees slightly flexed. Arms are flexed at elbows and wrists. The patient is slow in getting started. Steps are short and often shuffling. Arm swings are decreased and the patient turns around stiffly— "all in one piece."

Speed, balance, and agility decrease with aging. Steps become short, uncertain, and even shuffling. The legs may be flexed at hips and knees. A cane may bolster lost confidence.

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