Article

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.

Langue : ANGLAIS