Table 1

Common varieties of functional gait disorder (from Lempert et al, 199120)

Clinical featuresDescriptionn*
* Number displaying this feature in a series of 37 patients with functional gait disorder.
†Excluded from Lempert's classification but one of the most common gait abnormalities.
1Monoplegic “dragging” gaitA leg that drags behind the patient, often with rotation at the hip or inversion/eversion at the ankle. Leg often hauled on to bed with both hands.N/A†
2Fluctuation of impairmentVariability during a 5–10 minute period, either spontaneously or provoked by distraction, for example finger-nose testing while standing19
3Excessive slowness of movements or hesitationSimultaneous contraction of agonist and antagonist muscles—not related to pain in this sample. Hesitation refers to delayed or failed initiation of gait; small forward and backward movements of the leg while the feet “stick” to the ground; does not improve after the first step like parkinsonism.19
4“Psychogenic Romberg” test
  1. Constant falls towards or away from the observer, irrespective of position. Fall avoided by clutching physician.

  2. Large amplitude body sway.

  3. Improvement with distraction.

5“Walking on ice” patternThe gait pattern of a normal person walking on slippery ground. Cautious, broad based steps with decreased stride length and height, stiff knees and ankles. Arms sometimes abducted as if on a tightrope.11
6Uneconomic postures with waste of muscle energyA gait with an eccentric displacement of centre of gravity such as standing and walking with flexion of hips and knees.11
7Sudden knee bucklingPatients usually prevent themselves from falling (8/10) before they touch the ground, requiring excellent muscle function. NB, knee buckling can occur in Huntington's chorea and cataplexy.10