Observe patient from the front, back, and sides. Ask patient to rise quickly from chair, walk at slow pace, then fast pace, then turn around; walking successively on toes, on heels, and tandem.

Note body and head posture (normal = erect), shoulders (no scoliosis or kyphosis), arm swing (present and equal), foot base (narrow), stride (full, symmetric, without shuffling), cadence (regular), speed, steadiness, turning (in one step).

Combined effects of spasticity, incoordination, weakness. Affected arm flexed at elbow and leg extended. Paretic leg swings outward at the hip (circumduction). Paretic arm moves little, remaining flexed and adducted; arm swing.

Combined effects of spasticity, incoordination, weakness of both legs. Slow, stiff movements at knees and hips, with evident effort. Legs usually maintained extended or slightly flexed at hips and knees, often adducted at hips. Short steps, side-to-side trunk movements, circumduction of legs. Each leg may cross in front of the other (“scissors gait”).

Combined effects of akinesia (difficulty initiating movement), dystonia (fixed abnormal posture), rigidity, and tremor.

Difficulty rising from chair. Flexed posture with few automatic limb movements. Reduced arm swing. Short steps, sometimes becoming successively shorter and more rapid (festination).

Several steps for turning. Poor recovery of balance when pulled from behind; normals restore balance with 1–2 steps. Motor “freezing” (sudden brief inability to move legs). Rest tremor often emerges during walking.

Wide-based stance, unsteady balance, cautious steps of variable length and cadence; lurching from side to side (“ataxic gait”).

Narrow-based stance difficult to attain with eyes open or closed. In mild disease, problem may appear only on tandem-walking.