Functional gait disorders: Demographic and clinical correlations

Tinazzi, Michèle; Padovani, Alessandro; Morgante, Francesca; Marcuzzo, Enrico; Cuoco, Sofia; Ceravolo, Roberto; Mazzucchi, Sonia; Padovani, Alessandro; Romito, Luigi; Eleopra, Roberto; Dallocchio, Carlo; Arbasino, Carla; Bono, Francesco; Magro, Giuseppe; Demartini, Benedetta; Gambini, Orsola; Modugno, Nicola; Olivola, Enrica; Bonanni, Laura; Zanolin, Elisabetta; Albanese, Alberto; Ferrazzano, Gina; Tessitore, Alessandro; Lopiano, Leonardo; Calandra‐Buonaura, Giovanna; Petracca, Martina; Esposito, Marcello; Pisani, Antonio; Manganotti, Paolo; Tesolin, Lucia; Teatini, Francesco; Defazio, Giovanni; Ercoli, Tommaso; Stocchi, Fabrizio; Erro, Roberto; Zappia, Mario; Geroin, Christian

doi:10.1016/j.parkreldis.2021.08.012

Cited by 4 publications

(3 citation statements)

References 12 publications

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“…Exercise movement was the most frequently observed trigger, followed by emotional, visual, touch, and auditory stimuli, all leading to a manifestation of FMD in various body parts, especially in the lower and the upper limbs. Moreover, we found no differences in the clinical and demographical variables between T-FMD and NoT-FMD, with the exception of younger age and more gait disorder [ 24 ] in the T-FMD group suggesting triggers don’t describe a discrete group of individuals with FMD [ 25 ].…”

Section: Discussionmentioning

confidence: 99%

Triggers in functional motor disorder: a clinical feature distinct from precipitating factors

et al. 2022

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Background and objective People with functional motor disorder (FMD) report triggers—sensory or motor-induced stimuli that exacerbate or initiate paroxysmal occurrences of their movement disorder. These are a distinct phenomenon from precipitating factors occurring at the initial onset of the disorder. We aimed to assess triggers in FMD and understand their relevance to paroxysmal variability often seen in FMD. Methods We enrolled consecutive outpatients with a definite diagnosis of FMD. Each patient underwent a detailed clinical evaluation also including the presence of trigger factors and video-recordings both during neurological examination and physiotherapy treatment. Patients were classified as having “triggers” (T-FMD) or “not having triggers” (NoT-FMD) as well as “paroxysmal” compared to “persistent with paroxysmal variability”. Results The study sample was 100 patients (82% female) with FMD; the mean age at onset was 41 years. Triggers were observed in 88% of patients and in 65 of these the FMD was pure paroxysmal. The most common triggers were movement or physical exercise, followed by emotional, visual, touch, and auditory stimuli; 39 (44%) were isolated and 49 (56%) were combined triggers. Among the T-FMD patients, FMD were paroxysmal in 74% (n = 65) and persistent with paroxysmal variability in 26% (n = 23). The T-FMD patients were younger (p = 0.016) and had a gait disorder (p = 0.035) more frequently than the NoT-FMD patients. Discussion Triggers are frequent in FMD and may have diverse overlapping clinical presentations. In this sample, FMD was most often paroxysmal, suggesting the value of noting triggers as clinical clues in the diagnosis and rehabilitation of FMD.

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Section: Discussionmentioning

confidence: 99%

Triggers in functional motor disorder: a clinical feature distinct from precipitating factors

et al. 2022

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“…The incidence ranges from 4 to 12 per 100,000 population per year, accounting for 15–20% of patients seeking neurological care, 3–5 where positive signs prove incongruent with organic movement disorders 3,6,7 . People with FMDs (PwFMD) often report gait and balance disorders (along with dystonia, weakness, and tremor), which increase the risk of falls and disability 3,8–10 . Like other movement disorders, FMDs are associated with long‐term disability, poor quality of life, distress, and an economic burden on health and social care 11,12 .…”

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confidence: 99%

“… 3 , 6 , 7 People with FMDs (PwFMD) often report gait and balance disorders (along with dystonia, weakness, and tremor), which increase the risk of falls and disability. 3 , 8 , 9 , 10 Like other movement disorders, FMDs are associated with long‐term disability, poor quality of life, distress, and an economic burden on health and social care. 11 , 12 Since the early 2000s, breakthroughs in PwFMD pathophysiology and management 1 , 13 , 14 , 15 have helped set the disorder into a biopsychosocial framework, where predisposing, precipitating, and perpetuating factors lead to symptoms’ manifestation.…”

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confidence: 99%

How Does Postural Control in Patients with Functional Motor Disorders Adapt to Multitasking‐Based Immersive Virtual Reality?

Gandolfi,

Sandri,

Menaspà

et al. 2024

Movement Disord Clin Pract

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BackgroundMotor symptoms in functional motor disorders (FMDs) refer to involuntary, but learned, altered movement patterns associated with aberrant self‐focus, sense of agency, and belief/expectations. These conditions commonly lead to impaired posture control, raising the likelihood of falls and disability. Utilizing visual and cognitive tasks to manipulate attentional focus, virtual reality (VR) integrated with posturography is a promising tool for exploring postural control disorders.ObjectivesTo investigate whether postural control can be adapted by manipulating attentional focus in a 3D immersive VR environment.Methodswe compared postural parameters in 17 FMDs patients and 19 age‐matched healthy controls over a single session under four increasingly more complex and attention‐demanding conditions: simple fixation task (1) in the real room and (2) in 3D VR room‐like condition; complex fixation task in a 3D VR city‐like condition (3) avoiding distractors and (4) counting them. Dual‐task effect (DTE) measured the relative change in performance induced by the different attention‐demanding conditions on postural parameters.ResultsPatients reduced sway area and mediolateral center of pressure displacement velocity DTE compared to controls (all, p <0.049), but only under condition 4. They also showed a significant reduction in the sway area DTE under condition 4 compared to condition 3 (p=0.025).ConclusionsThis study provides novel preliminary evidence for the value of a 3D immersive VR environment combined with different attention‐demanding conditions in adapting postural control in patients with FMDs. As supported by quantitative and objective posturographic measures, our findings may inform interventions to explore FMDs pathophysiology.This article is protected by copyright. All rights reserved.

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Dual tasking affects gait performance but not automaticity in functional gait disorders: A new diagnostic biomarker

Gandolfi

Fiorio

Geroin

et al. 2023

Parkinsonism & Related Disorders

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Functional gait disorders: Demographic and clinical correlations

Cited by 4 publications

References 12 publications

Triggers in functional motor disorder: a clinical feature distinct from precipitating factors

Triggers in functional motor disorder: a clinical feature distinct from precipitating factors

How Does Postural Control in Patients with Functional Motor Disorders Adapt to Multitasking‐Based Immersive Virtual Reality?

Dual tasking affects gait performance but not automaticity in functional gait disorders: A new diagnostic biomarker

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