Which of the following is a typical feature of hemiplegic gait?

• A. Circumduction of the affected leg
• B. Wide base with staggering
• C. Small shuffling steps with stooped posture
• D. Toeing inwards

Answer: (A)

Circumduction of the affected leg is seen in hemiplegic gait because a one-sided brain or spinal injury causes weakness and spasticity on that side, especially around the hip and ankle. With the foot often unable to dorsiflex properly and the ankle held in plantarflexion by spastic muscles, the foot cannot clear the floor during the swing phase. To move the leg forward despite this, the leg is swung outward in a circular arc around the stance leg—that outward, circular swing is the circumduction. You may also see compensatory hip hiking or knee flexion patterns, but the hallmark is the outward swing of the leg to clear the foot. Other gait patterns point to different conditions (wide-based, staggering gait for ataxia; small shuffling steps with stooped posture for Parkinsonism; toeing inward is not typical of a classic hemiplegic gait).