P124. Evaluation of gait parameters in functional gait disorders

Publication date: August 2018

Source: Clinical Neurophysiology, Volume 129, Issue 8

Author(s): K. Breitkopf, J. Decker, M. Wuehr, F. Schenkel, T. Brandt, R. Schniepp

Objective

To identify thresholds for pathognomonic gait parameters in functional gait disorders.

Background

Characteristics of functional gait disorders are e.g. transient fluctuations in stance and gait, excessive slowness or hesitation that is not compatible with neurological disease, uneconomic postures with wastage of muscular energy, the 'walking on ice' gait pattern with typical small cautious steps with fixed ankle joints and sudden buckling of the knees that generally do not lead to falls (Lempert et al., 1991). Early diagnosis is important: Over half of the patients with psychogenic disorder of stance and gait remain unchanged after five and a half years. If the disorder is present no longer than four months complete remission can often be achieved (Brandt et al., 1994).

Methods

We used a pressure-sensitive GAITRite© carpet to assess gait analysis during eight gait conditions (three different walking speeds, two sensory and three cognitive tasks). Each of the 23 gait parameters was edited with custom software. A binary logistic regression, ROC (receiver operating characteristic) analysis and an inversed regression were performed to identify thresholds for pathological deviations from normal range.

Results

In the preferred speed condition, patients with functional gait disorder differed from healthy subjects in all gait parameters, particularly in velocity, spatial, and variability measures. In the cognitive dual task condition (i.e. dual task words), however, the gait parameters almost normalized, especially the variability parameters assimilate healthy subjects.

Conclusion

Characteristics of gait parameters of patients with functional gait disorder were similar to postural performance in patients with phobic postural vertigo (PPV; Wuehr et al., 2017): The dual-task effect in patients with functional gait disorder revealed that cognitive distraction led to a normalization in walking. This is typical for functional disorders and can also be observed in patients with PPV.

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