Physical examination maneuver

Physical Exam

Gait Assessment

🎬
Video coming September 2026

How to Perform

Ask the patient to walk a short distance away from you, turn, and walk back at a natural pace. Observe the stance width, step length and symmetry, arm swing, posture, turning, and any limp, unsteadiness, or involuntary movements.

How to Interpret

Showing 5 of 34 findings

Dementia

Any gait or balance disorder in a patient with dementia, detecting a non-Alzheimer dementia
Rule in
Somewhat helpfulDerived CI
Rule out
Somewhat helpfulDerived CI
Evidence:Limited

Falls

Stops walking when talking in an older adult in residential care, predicting falls within six months
Rule in
HelpfulDerived CI
Rule out
Minimally helpfulDerived CI
Evidence:Limited

Focal Cerebral Hemisphere Lesion

Asymmetric arm swing
Rule in
InconclusiveWide CI
Rule out
Not helpfulDerived CI
Evidence:Limited

Stroke

Severe truncal ataxia in a patient with acute vestibular syndrome
Rule in
Very helpful
Rule out
Minimally helpful
Evidence:Strong

Vascular Parkinsonism

Lower body parkinsonism in a patient presenting with parkinsonism
Rule in
HelpfulDerived CI
Rule out
Somewhat helpfulDerived CI
Evidence:Limited

References

  • Rao G, Fisch L, Srinivasan S, D'Amico F, Okada T, Eaton C, Robbins C. Does this patient have Parkinson disease? JAMA. 2003;289(3):347-353. doi:10.1001/jama.289.3.347. PMID 12525236.
  • Rao G, Fisch L, Srinivasan S, D'Amico F, Okada T, Eaton C, Robbins C. Does this patient have Parkinson disease? JAMA. 2003;289(3):347-353. PMID: 12525236.
  • Rao G, Fisch L, Srinivasan S, et al. Does this patient have Parkinson disease? JAMA. 2003;289(3):347-353. PMID: 12525236.
  • Winikates J, Jankovic J. Clinical correlates of vascular parkinsonism. Arch Neurol. 1999;56(1):98-102. PMID: 9923767.
  • Clegg A, Rogers L, Young J. Diagnostic test accuracy of simple instruments for identifying frailty in community-dwelling older people: a systematic review. Age Ageing. 2015;44(1):148-152. doi:10.1093/ageing/afu157. PMID 25355618.
  • Allan LM, Ballard CG, Burn DJ, Kenny RA. Prevalence and severity of gait disorders in Alzheimer's and non-Alzheimer's dementia. J Am Geriatr Soc. 2005;53(10):1681-1687. PMID: 16181166.
  • Lundin-Olsson L, Nyberg L, Gustafson Y. "Stops walking when talking" as a predictor of falls in elderly people. Lancet. 1997;349(9052):617. PMID: 9057736.
  • Martinez C, Wang Z, Zalazar G, Carmona S, Kattah JC, Tarnutzer AA. Systematic Review and Meta-Analysis of the Diagnostic Accuracy of a Graded Gait and Truncal Instability Rating in Acutely Dizzy and Ataxic Patients. Cerebellum. 2024;23(6):2244-2256. doi:10.1007/s12311-024-01718-6. PMID: 38990511.
  • Anderson NE, Mason DF, Fink JN, Bergin PS, Charleston AJ, Gamble GD. Detection of focal cerebral hemisphere lesions using the neurological examination. J Neurol Neurosurg Psychiatry. 2005;76(4):545-549. PMID: 15774443. PMC1739581.
  • Koller WC, Trimble J. The gait abnormality of Huntington's disease. Neurology. 1985;35(10):1450-1454. PMID: 3162109.
  • Bickley LS, Szilagyi PG, Hoffman RM, Soriano RP. Bates' Guide to Physical Examination and History Taking. 13th ed. Philadelphia, PA: Wolters Kluwer; 2021.
  • Swartz MH. Textbook of Physical Diagnosis: History and Examination. 9th ed. Philadelphia, PA: Elsevier; 2025.

Research last updated September 10, 2026.

Related Chief Complaints

Abdominal DistensionAbnormal MovementsArm WeaknessBack PainBalance ProblemsBladder ProblemsBreast TendernessBurning FeetClumsinessCognitive DeclineConfusionConstipationDevelopmental DelayDifficulty Climbing StairsDifficulty Lifting the ArmDifficulty Lifting the FootDifficulty Rising From a ChairDifficulty SpeakingDifficulty WalkingDifficulty with Daily TasksDizzinessDouble VisionDroolingElectric Shock with Neck BendingEye Pain with MovementFacial DroopFatigueFood CravingsFoot DeformityFoot DropFoot NumbnessFoot PainFrequent FallsFrequent TrippingFrequent UrinationGroin PainHand ClumsinessHeadacheHigh ArchesHip PainHip StiffnessHip WeaknessLeg AchingLeg CrampsLeg DiscomfortLeg NumbnessLeg PainLeg SwellingLeg WeaknessLimpLoss of ConsciousnessLoss of CoordinationLoss of SensationLoss of SmellLow EnergyLower Extremity PainMemory LossMissed PeriodMuscle StiffnessNausea and VomitingNumbnessNumbness on One SideNumbness on Top of the FootPain with Hip RotationPersonality ChangePins and NeedlesResting TremorSciaticaSeizureSevere PainShooting Leg PainShoulder WeaknessShuffling GaitSlapping GaitSlow WalkingSlowness of MovementSlurred SpeechSmall HandwritingSoft VoiceSpasticityStiffnessSudden NumbnessSudden Vision LossSudden WeaknessTinglingTingling in the LegTremorTrippingUnintentional Weight LossUnsteady GaitUrinary IncontinenceVision ChangesVision Loss in One EyeWeak AnklesWeaknessWeakness on One SideWorse Balance in the Dark

Related Systems / Regions

Neurological

Related Bedside Tests

🎬Video coming Sept 2026
Babinski Reflex
aka Plantar reflex
Rule in:VHUpper Motor Neuron Lesion, VHVascular Parkinsonism, IEMotor Neuron Disease +4 more
Rule out:SHUpper Motor Neuron Lesion, NHVascular Parkinsonism, IEMotor Neuron Disease +4 more
🎬Video coming Sept 2026
Pronator Drift
Rule in:VHBrain Tumor, VHFunctional Neurologic Disease, HStroke +5 more
Rule out:VHFunctional Neurologic Disease, VHStroke, MHBrain Tumor +5 more
🎬Video coming Sept 2026
Achilles Deep Tendon Reflex
aka Ankle jerk
Rule in:VHPeripheral Neuropathy, SHHypothyroidism, NHLumbosacral Radiculopathy +5 more
Rule out:VHPeripheral Neuropathy, ICHypothyroidism, NHLumbosacral Radiculopathy +5 more
🎬Video coming Sept 2026
Patellar Deep Tendon Reflex
aka Knee jerk
Rule in:VHPeripheral Neuropathy, SHLumbosacral Radiculopathy, IECerebellar Disease +5 more
Rule out:SHPeripheral Neuropathy, ICLumbosacral Radiculopathy, IECerebellar Disease +5 more
🎬Video coming Sept 2026
Finger-to-nose
Rule in:VHStroke, IECerebellar Disease, IEMultiple Sclerosis +2 more
Rule out:NHStroke, IECerebellar Disease, IEMultiple Sclerosis +2 more
🎬Video coming Sept 2026
Heel-to-shin
aka Heel-knee-shin test
Rule in:IECerebellar Disease, IEMultiple Sclerosis, IESensory Ataxia
Rule out:IECerebellar Disease, IEMultiple Sclerosis, IESensory Ataxia