Gait, coordination and abnormal movements
When examining gait and coordination, the results must be interpreted in the light of any motor or sensory findings in the rest of the examination. Patients with significant weakness or posterior column sensory loss will have some loss of coordination. There may be additional incoordination, and assessment of this is difficult and is based on a judgement as to whether the incoordination is disproportionate to the weakness or sensory loss.
Coordination
In testing coordination, look for smoothness and accuracy of movement. The standard manoeuvres used for bed-side testing are finger–nose coordination (Fig. 1), fast repeated movements and heel–shin testing (Fig. 2). Other parts of the examination afford an opportunity to observe coordination, for example the way the patient gets dressed and undressed and does up buttons.
Finger–nose coordination
Hold out your finger about 50 cm in front of the patient’s face. Ask the patient to touch your finger with his or her finger and then touch the nose. Ask the patient to repeat this (Fig. 1).
