Steppage, Stepping Gait

Steppage, Stepping Gait

Steppage or stepping gait occurs with a lower motor neurone type of foot drop ("floppy" foot drop), e.g., due to a common peroneal nerve palsy, peripheral neuropathies. Because of the weakness of foot dorsiflexion (weak tibialis anterior) there is compensatory overaction of hip and knee flexors during the swing phase of walking to ensure the foot clears the ground. In the strike phase, there is a characteristic slapping down of the foot, again a consequence of weak ankle dorsiflexion. Proprioceptive loss, as in dorsal column spinal disease, may also lead to a gait characterized by high lifting of the feet, and also stomping (stamping with a heavily accented rhythm) or slapping of the foot onto the floor in the strike phase.
The pattern of gait with upper motor neurone foot drop ("stiff " foot drop), e.g., due to a corticospinal tract lesion, is quite different, with the foot being dragged, sometimes with circumduction of the leg. This may leads to falls as a consequence of tripping over the foot, especially on up-hill gradients, and a characteristic pattern of wear on the point of the shoe.

Cross References

Foot drop; Lower motor neurone (LMN) syndrome; Proprioception; Rombergism, Romberg’s sign; Upper motor neurone (UMN) syndrome