Lumbar Spinal Stenosis Symptoms and Presentation
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Questions and Answers

What is the characteristic feature of an antalgic gait?

  • Walking as if there were a thorn in the sole of the foot (correct)
  • Limited range of motion and avoidance of weight-bearing
  • Fixed ankle position while lifting and lowering the foot
  • Unconscious adaptive trunk shift during stance phase
  • In patients with hip pain, what is the typical trunk movement during the stance phase on the affected leg?

  • Shift away from the affected side
  • Shift towards the affected side (correct)
  • Conscious elevation of the foot
  • Unconscious fixing of the ankle position
  • What distinguishes coxalgic gait from waddling gait caused by gluteus medius muscle weakness?

  • Fixed ankle position while lifting and lowering the foot
  • Contralateral hemipelvis dropping during the stance phase (correct)
  • Unconscious trunk shift towards the affected side
  • Conscious elevation of the foot to reduce load
  • Which condition may cause painful lower extremities resulting in an antalgic gait?

    <p>Knee osteoarthritis</p> Signup and view all the answers

    What is the main treatment approach for spastic paraparetic gait?

    <p>Physiotherapy</p> Signup and view all the answers

    What is a characteristic feature of spastic paraparetic gait?

    <p>Stiff and insecure gait</p> Signup and view all the answers

    In cases of marked muscle tone in the adductors, what type of gait disorder may result?

    <p>Scissor gait</p> Signup and view all the answers

    Which medication may be used to help alleviate spasticity in spastic paraparetic gait?

    <p>Muscle relaxants like baclofen</p> Signup and view all the answers

    What distinguishes sensory ataxia from cerebellar ataxia?

    <p>Compensation by visual input for proprioceptive loss</p> Signup and view all the answers

    What type of gait may be observed in cerebellar ataxia?

    <p>Broad-based and wobbly gait</p> Signup and view all the answers

    Which region of the cerebellum is predominantly responsible for the control of balance?

    <p>Vermis region</p> Signup and view all the answers

    What type of disturbances may occur in sensory polyneuropathy or dorsal column lesions?

    <p>Proprioceptive disturbances</p> Signup and view all the answers

    What type of compensation do patients with sensory ataxic gait use for the loss of proprioception?

    <p>Visual control</p> Signup and view all the answers

    Which test may reveal less difference in cerebellar ataxia compared to sensory ataxia?

    <p>Tandem walk test</p> Signup and view all the answers

    What may cause a worsening of ataxic gait and the associated risk of falling in sensory ataxia?

    <p>Walking in darkness</p> Signup and view all the answers

    Which region of the cerebellum is important for the control of the timing and amplitude of targeted limb movements?

    <p>Paravermal structures</p> Signup and view all the answers

    Which type of gait disorder is characterized by an excessive fear of falling, leading to a complete inability to walk?

    <p>Cautious gait</p> Signup and view all the answers

    What type of gait disorder is mainly characterized by a stiff and paraparetic spastic gait, but may also be spastic-ataxic due to dorsal column dysfunction?

    <p>Myelopathic gait</p> Signup and view all the answers

    What non-surgical treatment includes training how to lift the pelvis while standing and walking or corsets to counteract lumbar lordosis?

    <p>Myelopathic gait</p> Signup and view all the answers

    In which type of gait disorder should surgical decompression be considered in symptomatic cases due to its progressive nature?

    <p>Myelopathic gait</p> Signup and view all the answers

    Which type of gait disorder is characterized by a dominance of the tonus in the upper limb flexor muscles and a slow, wide-based, asymmetrical gait?

    <p>Spastic hemiparetic gait</p> Signup and view all the answers

    What type of gait disorder is mainly caused by narrowing of the spinal canal and mechanical compression of the cervical spinal cord?

    <p>Myelopathic gait</p> Signup and view all the answers

    Which type of gait disorder is associated with deep muscular pain and neurological deficits such as sensory deficits and paresis in the lower limbs during walking?

    <p>Myelopathic gait</p> Signup and view all the answers

    What type of non-surgical treatment may include corsets to counteract lumbar lordosis for certain types of gait disorders?

    <p>Myelopathic gait</p> Signup and view all the answers

    In which type of gait disorder should walking uphill be better tolerated than walking downhill?

    <p>Myelopathic gait</p> Signup and view all the answers

    Which type of gait disorder typically presents with urinary urgency in severe cases?

    <p>Myelopathic gait</p> Signup and view all the answers

    What non-surgical treatment includes training on how to lift the pelvis while standing and walking for certain types of gait disorders?

    <p>Myelopathic gait</p> Signup and view all the answers

    In which type of gait disorder is walking uphill better tolerated than walking downhill due to the associated symptoms?

    <p>Myelopathic gait</p> Signup and view all the answers

    What is the result of thickening of the ligamentum flavum and a decrease in the gap between the posterior margin of the intervertebral disc and the facet joints?

    <p>Reduction of the diameter of the spinal canal and dural sac</p> Signup and view all the answers

    What is a common cause of knee hyperextension during the early stance phase?

    <p>Quadriceps muscle weakness</p> Signup and view all the answers

    In patients with differences in leg length, how does the body move with each step?

    <p>The head and trunk bend towards the affected side</p> Signup and view all the answers

    What is a characteristic gait pattern in patients with myopathies affecting the muscles extending the hip joint?

    <p>Waddling gait</p> Signup and view all the answers

    What is a common feature of steppage gait?

    <p>Inability to stand or walk on heels</p> Signup and view all the answers

    What is a symptom of intermittent claudication?

    <p>Pain or cramps in the calves, feet or thighs during walking</p> Signup and view all the answers

    What is a characteristic symptom of lumbar spinal stenosis and neurogenic claudication?

    <p>$ ext{Pain or cramps in the legs on standing or walking}$</p> Signup and view all the answers

    What does kyphosis and ankylosing spondylitis result in?

    <p>$ ext{Truncal immobility}$</p> Signup and view all the answers

    What is a characteristic feature of waddling gait caused by weakness in the gluteus medius muscle?

    <p>$ ext{Trendelenburg sign}$</p> Signup and view all the answers

    What is a common cause of peripheral paresis that leads to gait disorders?

    <p>$ ext{Orthopaedic conditions}$</p> Signup and view all the answers

    How do patients with spinal pain typically modify their gait?

    <p>$ ext{Avoid heel strike during the early stance phase}$</p> Signup and view all the answers

    What leads to an instability of the pelvis on standing and walking, resulting in a characteristic waddling gait?

    <p>$ ext{Weakness of the gluteus medius muscle}$</p> Signup and view all the answers

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