This atlas is aimed at all doctors and other health care professionals who need to be able to diagnose and cure disorders of gait. General practitioners, neurologists, orthopaedists, physiotherapists and other specialists all find that disorders of gait, balance and falls are among their patients' most frequent complaints. However, gait evaluation is often underestimated. Both during general physical examinations and specialist neurological examinations, gait is usually examined at the close, and is thus seen as only an addition to syndromological balance based on other symptoms and findings. Meanwhile, characteristic gait disorders can often aid a diagnosis the minute a patient walks into the room.
Although modern mechanical examination methods have made it considerably easier to arrive at an etiological diagnostics of gait disorders, simple observation still remains the basic approach, the 'gold standard' of gait examination. It allows the experienced observer to extract the decisive information necessary for a differential diagnosis of a movement disorder. However, the traditional descriptive labels of certain gait disorders do not necessarily mean they are easy to diagnose. Labelling gait disorders according to the systems affected, or even according to nosological units, is difficult because of a combination of formulae and overlapping clinical pictures. In the classification of gait disorders that we provide here, we prefer to use a semiological division according to the basic features apparent when the patient is observed. Clinically-observed gait disorders can be composed of several basic semiological elements, which blend together in the resulting formula. The clinical-anatomical classification thus results from the likely location of the damage that causes the relevant gait disorder.
The authors would like to thank all their colleagues at the Neurological Clinic of the 1st Medical Faculty at Charles University in Prague, who examined patients and made several video recordings. Special thanks are due to Dr. Ivana Wurstová, who allowed us to record the gait of selected patients at Velké Losiny Spa. This work would not have been possible without the understanding and cooperation of the patients, who agreed that recordings of their gait disorders could be used for educational purposes.