Equilibrator Coordination
Walking backward is much easier in paresis or paralysis of the quadriceps femora’s then walking forward. To elicit further the presence of equilibrator ataxia in walking the following tests are employed: the patient is asked to rise on command and thirdly, he is asked to walk and turn around quickly ob sharp command. The ataxic gait is thereby brought out even though it be absent in normal walking.
Normally there is associated swinging of the arms in walking. These movements are quite automatic and they are lost in paralysis agates syndrome, either unilaterally or bilaterally. The patient walks rigidly, the trunk, head and limbs constituting one piece as it were. He is stooped forward; there is no expression to his gait. He sits down or raises stiffly, the arm hanging fixedly by his side, the head held rigid. Loss of associated movement may also occur in cerebella disease. Immobility of the neck may be due to cervical sodalities or mysticism, fracture of the cervical spine, tumors of the spinal cord, tuberculosis sodalities, etc.
While the patient is still on his feet equilibrator coordination is examined by means of the Romberg test. An ataxic person generally stands on a broad base. Standing with feet together, eyes first open, and then closed, swaying is noticed. If this increases or is brought out on shutting the eyes, with head titled back, the Romberg sign is present. The same thing may be tested with the patient standing first on one foot, then on the other. The Romberg sign must be properly evaluated, and the swaying differentiated from the jerking of the hysteric who, when observed, immediately flops in all direction, but never falls. The reason for having the eyes open and closed in testing fro the Romberg sign or any other of manifestation of in coordination is that we can thereby differentiate between cerebella and so called cerebral or sensory ataxia.
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