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J Rehabil Med. 2014 Feb;46(2):181-7. doi: 10.2340/16501977-1246.

Psychogenic gait disorder: a randomized controlled trial of physical rehabilitation with one-year follow-up.

Author information

1
Vestfold Hospital Trust, Clinic physical medicine and rehabilitation, NO-3101 Tønsberg, Norway. Anika.Jordbru@siv.no, Anika.Jordbru@rehabilitering.net.

Abstract

OBJECTIVE:

Psychogenic gait disorder, defined as loss of ability to walk without neurological aetiologies, has poor rehabilitation options that are well documented. Left untreated these patients have substantial and long-lasting dysfunction. The present study examined the effect of a 3-week inpatient rehabilitation programme compared with a waiting list control condition, and whether eventual gains were maintained at 1-month and 1-year follow-up.

DESIGN:

A cross-over design evaluated the effect of treatment, and a carry-over effect was considered as a long-lasting treatment effect. Treatment consisted of adapted physical activity within a cognitive behavioural framework, and focused on offering an alternative explanation of symptoms, positively reinforcing normal gait and not reinforcing dysfunction.

PATIENTS:

A total of 60 patients were recruited from neurological departments and were randomly assigned to immediate treatment (intervention) or treatment after 4 weeks (controls).

RESULTS:

Cross-over design revealed that the mean difference between treatment vs no treatment was 8.4 Functional Independence Measure units (p < 0.001, 95% confidence interval 5.2-11.7), and 6.9 Functional Mobility Scale units (p < 0.001, 95% confidence interval 5.5-8.3). Patients significantly improved their ability to walk and their quality of life after inpatient rehabilitation compared with the untreated control group. The improvements in gait were sustained at 1-month and 1-year follow-up.

CONCLUSION:

Substantial and lasting improvement can be achieved by inpatient rehabilitation of patients with psychogenic gait, and the gains are maintained during follow-up.

PMID:
24248149
DOI:
10.2340/16501977-1246
[Indexed for MEDLINE]
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