Abnormal gait in neurologic disease

For most people, walking is an automatic, unconscious activity, characteristic of each individual. Patterns of gait can be reflective of a person's body structure, occupation, and personality, as well as health status. Most parents who watch an infant beginning to walk realize that locomotion is a highly complex, learned process. Years of training and practice are necessary for the sensory-motor system to become adept at automatically generating the motor commands necessary to permit walking without conscious effort. The characteristic adult pattern of walking does not emerge until up to 7 to 9 years of age, after the neuromusculoskeletal systems have undergone constant modification and development of improved neural controls. Important information pertinent to the patient's health status can be obtained by observing his or her manner of walking. This article will review abnormal gait patterns due to nervous system dysfunction. To help understand abnormal gaits, a brief review of the underlying components of walking is necessary.