Station Progress:

[vc_row row_type=”row” use_row_as_full_screen_section=”no” type=”full_width” oblique_section=”no” text_align=”left” css_animation=””][vc_column][ultimate_heading main_heading=”Candidate brief” main_heading_color=”#000000″ sub_heading_color=”#000000″ main_heading_style=”font-weight:bold;” main_heading_font_size=”desktop:36px;”]

“This patient has complained of feeling unsteady.  Please examine their gait and present your findings to the examiners.”

[/ultimate_heading][vc_empty_space image_repeat=”no-repeat”][vc_video link=”https://vimeo.com/149071483″][vc_empty_space image_repeat=”no-repeat”][vc_row_inner row_type=”row” type=”full_width” use_row_as_full_screen_section_slide=”no” text_align=”left” css_animation=””][vc_column_inner width=”1/4″][stat_counter icon_size=”32″ counter_title=”Station Time” counter_value=”20″ counter_suffix=” minutes” speed=”3″][/vc_column_inner][vc_column_inner width=”1/4″][stat_counter icon_size=”32″ counter_title=”Time for this encounter” counter_value=”10″ counter_suffix=” minutes” speed=”3″][/vc_column_inner][vc_column_inner width=”1/4″][stat_counter icon_size=”32″ counter_title=”Maximum time to examine your patient” counter_value=”6″ counter_suffix=” minutes” speed=”3″][/vc_column_inner][vc_column_inner width=”1/4″][stat_counter icon_size=”32″ counter_title=”Minimum time for discussion and questions” counter_value=”4″ counter_suffix=” minutes” speed=”3″][/vc_column_inner][/vc_row_inner][vc_empty_space image_repeat=”no-repeat”][/vc_column][/vc_row][vc_row row_type=”row” use_row_as_full_screen_section=”no” type=”full_width” oblique_section=”no” text_align=”left” css_animation=””][vc_column][vc_accordion style=”accordion”][vc_accordion_tab title=”Common examiner questions”][vc_column_text]

  1. What do you think about this patient’s gait?
  2. How would you investigate further?

[/vc_column_text][/vc_accordion_tab][vc_accordion_tab title=”Diagnosis and clinical signs”][vc_column_text]This patient has a normal gait.  There are no clinical signs displayed.[/vc_column_text][/vc_accordion_tab][vc_accordion_tab title=”Discussion”][vc_column_text]

Gait analysis

As greater numbers of elderly patients require healthcare from the NHS the importance of understanding how to examine a patient’s gait has grown.  Although not typically regarded as a classical part of clinical examination in it’s own right, it is increasingly important for physicians to be able to determine the underlying problems that lead to a patient’s difficulty in mobilising.  This is important as the cost to society simply of a patient being unable to transfer is very significant indeed in terms of increased care requirements.

Normal gait

Legs alternate between stance and swing phases:

Stance phase:
  1. Initial contact (also known as heel strike);
  2. Load response (foot flat);
  3. Mid-stance (single leg stance);
  4. Push off:
    1. Terminal stance – heel off;
    2. Toe off.
Swing phase
  1. Initial swing;
  2. Mid-swing;
  3. Terminal swing.

Examination of a patient’s gait should properly commence with the patient seated in a chair or lying on a couch and assessing their ability to transfer to standing.  Many patients are able to walk adequately once axially loaded, but are unable to manouvre into a standing position in the first place – with significant implications for their mobility.

Next, ask your patient if they use a walking aid and hand it to them if accessible.

Then ask your patient to walk a few yards, turn around and come back again.

If they manage this successfully you can also ask them to heel-toe walk and conduct Romberg’s test before thanking your patient and helping them sit down again.[/vc_column_text][/vc_accordion_tab][vc_accordion_tab title=”Specimen case presentation”][vc_column_text]”This patient has a normal gait.”[/vc_column_text][/vc_accordion_tab][/vc_accordion][/vc_column][/vc_row]