Tandemgang

Tandemgang, or tandem gait, is a clinical maneuver used in neurological examination to assess balance, coordination, and gait control. In this test, the patient walks in a straight line with the heel of one foot placed directly in front of the toes of the other foot, creating a heel-to-toe sequence. The examiner observes for step accuracy, stability, stride, and the ability to maintain a straight path.

Procedure and interpretation: The patient is asked to walk a short distance along a line or a taped path. The clinician looks for a narrow, straight line of progression, minimal lateral sway, and consistent foot placement. Normal performance typically includes stable, coordinated steps with minimal hesitation. Abnormal findings may include a broad-based or irregular gait, repeated missteps, wide stance, veering to one side, stumbling, or the need to stop to recover balance. In some cases, the test can be repeated with the patient’s eyes closed to further challenge proprioception and vestibular function, though this increases fall risk and requires supervision.

Clinical use: Tandem gait is used to detect cerebellar ataxia, proprioceptive deficits, or vestibular dysfunction and may aid in evaluating suspected neurological conditions such as spinocerebellar disorders, intoxication, or acute vestibular illness. It is typically one element of a broader neurological examination and is interpreted in the context of other signs and symptoms, as factors like age, musculoskeletal pain, or arthritis can affect performance.