A 78-year-old man has a history of a cerebrovascular accident. The nurse notes that when he walks, his left arm is immobile against the body with flexion of the shoulder, elbow, wrist, and fingers and adduction of the shoulder. His left leg is stiff and extended and circumducts with each step. What type of gait disturbance is this individual experiencing?

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With spastic hemiparesis, the arm is immobile against the body. Flexion of the shoulder, elbow, wrist, and fingers occurs, and adduction of the shoulder, which does not swing freely, is observed. The leg is stiff and extended and circumducts with each step. Causes of this type of gait include cerebrovascular accident. With scissors gait the knees cross or are in contact, like holding an orange between the thighs, and the person uses short steps, and walking requires effort. The characteristics of cerebellar ataxia include a staggering, wide-based gait; difficulty with turns; and uncoordinated movement with positive Romberg sign. Parkinsonian gait presents with a stooped posture with trunk pitched forward. Elbows, hips and knees are flexed. Steps are short and shuffling. The gait disturbance of this patient is spastic hemiparesis. With spastic hemiparesis, the arm is immobile against the body. Flexion of the shoulder, elbow, wrist, and fingers occurs, and adduction of the shoulder, which does not swing freely, is observed. The leg is stiff and extended and circumducts with each step. Causes of this type of gait include cerebrovascular accident.

A 78-Year-Old Man Has a History of a Cerebrovascular Accident