You will be asked to examine the gait
- Stand and look
- Ask to remove trousers (even if stem is examine gait)
- At this point may not see anything as patient not walking
- Look for scars at knee, buttocks and scars at the back
- Look for wasting of muscles
- Look for Foot deformities [Pes cavus/ Planus], claw toes [think CMT]
- May see AFO or splints for foot drop/ walking aids
- Walk
- Foot drop gait with high steppage gait
- Loss of first rocker with slapping of the feet
- “I note that there is BILATERAL foot drop gait, will go on to evaluate for the level of involvement”
- Return and Stand
- Special test - ask to heel walk to confirm inability to.
- Check spine if you see there if foot drop.
- Check for spinal dysraphism
- Previous instrumentation for L4/5 radiculopathy
- Check Hands for interosseous wasting for CMT
- Lie patient down - Now the aim is to look for the level of foot drop
- Look closely for scars again - buttock, lateral knee
- Check correctibility of the foot drop (developed contractures?)
- Check sensory - DPN, SPN, PTN
- Check Motor
- Ankle dorsiflexion
- Eversion
- Inversion [L5]
- Hip abduction with patient at the side [L5]
- Check pulses