Heel Walking
How to Perform
- Ask the patient to walk on their heels.
Significance
- Inability to walk on the heels suggests distal weakness.
Causes of Inability to Heel Walk
Central Nervous System
- CNS lesion - ischaemia, haemorrhage, tumour, trauma, multiple sclerosis, infection, vasculitis
Peripheral Nerves
- L5 nerve root lesion - radiculopathy, spinal trauma, tumour
- Common peroneal nerve palsy - compression, trauma, tumour
- Mononeuritis multiplex - vasculitis, diabetic neuropathy, infection, paraneoplastic
- Peripheral polyneuropathy - Charcot-Marie-Tooth, Guillain Barre, CIDP, motor neurone disease, polio
Other
- Myopathy - inflammatory myositis, muscular dystrophy, paraneoplastic
Toe Walking
Interpretation
- Ask the patient to walk on their toes.
Significance
- Inability to maintain plantar flexion is indicative of muscular weakness or an S1 lesion.
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