Scissor gait
Encyclopedia
Scissor gait is a form of gait abnormality
primarily associated with spastic
cerebral palsy
. It is associated with an upper motor neuron
lesion.
. Hypertonia
in the legs, hips and pelvis means these areas become flexed, to various degrees, giving the appearance of crouching, while tight adductors produce extreme adduction
, presented by knees and thighs hitting, or sometimes even crossing, in a scissors-like movement while the opposing muscles, the abductors, become comparatively weak from lack of use. Most common in patients with spastic cerebral palsy, usually diplegic
and paraplegic varieties, the individual is often also forced to walk on tiptoe unless the plantarflexor muscles are released by an orthaepedic surgical procedure.
These features are most typical with the scissors gait and usually result in some form and to some degree regardless of the mildness or severity of the spastic CP condition:
Gait abnormality
Gait abnormality is a deviation from normal walking . Watching a patient walk is the most important part of the neurological examination. Normal gait requires that many systems, including strength, sensation and coordination, function in an integrated fashion...
primarily associated with spastic
Spastic
The word spastic is used differently depending on location which has led to some controversy and misunderstanding. Derived via Latin from the Greek spastikos , the word originally referred to a change in muscles affected by the medical condition spasticity, which is seen in spastic diplegia and...
cerebral palsy
Cerebral palsy
Cerebral palsy is an umbrella term encompassing a group of non-progressive, non-contagious motor conditions that cause physical disability in human development, chiefly in the various areas of body movement....
. It is associated with an upper motor neuron
Upper motor neuron
Upper motor neurons are motor neurons that originate in the motor region of the cerebral cortex or the brain stem and carry motor information down to the final common pathway, that is, any motor neurons that are not directly responsible for stimulating the target muscle...
lesion.
Presentation
This gait pattern is reminiscent of a marionetteMarionette
A marionette is a puppet controlled from above using wires or strings depending on regional variations. A marionette's puppeteer is called a manipulator. Marionettes are operated with the puppeteer hidden or revealed to an audience by using a vertical or horizontal control bar in different forms...
. Hypertonia
Hypertonia
Hypertonia a condition marked by an abnormal increase in muscle tension and a reduced ability of a muscle to stretch. It is caused by lesions to upper motor neurons in the central nervous system, which carry information from the central nervous system to the muscles and control posture, muscle...
in the legs, hips and pelvis means these areas become flexed, to various degrees, giving the appearance of crouching, while tight adductors produce extreme adduction
Adduction
Adduction is a movement which brings a part of the anatomy closer to the middle sagittal plane of the body. It is opposed to abduction.-Upper limb:* of arm at shoulder ** Subscapularis** Teres major** Pectoralis major** Infraspinatus...
, presented by knees and thighs hitting, or sometimes even crossing, in a scissors-like movement while the opposing muscles, the abductors, become comparatively weak from lack of use. Most common in patients with spastic cerebral palsy, usually diplegic
Spastic diplegia
Spastic diplegia, historically known as Little's Disease, is a form of cerebral palsy that is a neuromuscular condition of hypertonia and spasticity in the muscles of the lower extremities of the human body, usually those of the legs, hips and pelvis...
and paraplegic varieties, the individual is often also forced to walk on tiptoe unless the plantarflexor muscles are released by an orthaepedic surgical procedure.
These features are most typical with the scissors gait and usually result in some form and to some degree regardless of the mildness or severity of the spastic CP condition:
- rigidity and excessive adduction of the leg in swing
- plantar flexion of the ankle
- flexion at the knee
- adduction and internal rotation at the hip
- progressive contractures of all spastic muscles
- complicated assisting movements of the upper limbs when walking .
Conditions associated with a scissor gait
- Arthrogryposis
- Spastic diplegiaSpastic diplegiaSpastic diplegia, historically known as Little's Disease, is a form of cerebral palsy that is a neuromuscular condition of hypertonia and spasticity in the muscles of the lower extremities of the human body, usually those of the legs, hips and pelvis...
- Pernicious anemiaPernicious anemiaPernicious anemia is one of many types of the larger family of megaloblastic anemias...
- Cerebrovascular accident
- Cervical spondylosis with myelopathyMyelopathyMyelopathy refers to pathology of the spinal cord. When due to trauma, it is known as spinal cord injury. When inflammatory, it is known as myelitis. Disease that is vascular in nature is known as vascular myelopathy....
(a problem with the vertebrae in the neck) - Liver failureLiver failureAcute liver failure is the appearance of severe complications rapidly after the first signs of liver disease , and indicates that the liver has sustained severe damage . The complications are hepatic encephalopathy and impaired protein synthesis...
- Multiple sclerosisMultiple sclerosisMultiple sclerosis is an inflammatory disease in which the fatty myelin sheaths around the axons of the brain and spinal cord are damaged, leading to demyelination and scarring as well as a broad spectrum of signs and symptoms...
- Spinal cord trauma
- Spinal cord tumor
- Syphilitic meningomyelitis
- SyringomyeliaSyringomyeliaSyringomyelia is a generic term referring to a disorder in which a cyst or cavity forms within the spinal cord. This cyst, called a syrinx, can expand and elongate over time, destroying the spinal cord. The damage may result in pain, paralysis, weakness, and stiffness in the back, shoulders, and...
- other forms of Cerebral palsyCerebral palsyCerebral palsy is an umbrella term encompassing a group of non-progressive, non-contagious motor conditions that cause physical disability in human development, chiefly in the various areas of body movement....
External Links
- http://www.youtube.com/watch?v=iPje7VDj7_k&NR=1|spasticdiplegic gait YouTubeYouTubeYouTube is a video-sharing website, created by three former PayPal employees in February 2005, on which users can upload, view and share videos....
]