Shell Shock: Psychogenic Gait and Other Movement Disorders - A Film Review

Moscovich, Mariana; Estupinan, Danny; Qureshi, Muhammad; Okun, Michael S.

doi:10.7916/d89023hj

Tremor and Other Hyperkinetic Movements 2013

DOI: 10.7916/d89023hj

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Shell Shock: Psychogenic Gait and Other Movement Disorders - A Film Review

Mariana Moscovich

Danny Estupinan

Muhammad Qureshi

et al.

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Cited by 4 publications

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“…27 Psychogenic movement disorders have been identified as a consequence of war trauma. 28 Traditionally, gait speed has been assessed while patients walk overground; however, it can also be assessed while patients walk on a treadmill. Several studies have characterized gait similarities and differences between treadmill and overground walking.…”

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Overground and Virtual Reality Gait Speed Are Associated With Atypical Symptom Reporting in Active Duty Service Members With a History of Mild to Moderate Traumatic Brain Injury

Rosen

Delpy

Pape

et al. 2021

Journal of Head Trauma Rehabilitation

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Objective: Physical therapy following traumatic brain injury (TBI) can be negatively impacted by psychological symptoms, atypical symptom reporting, and response bias. We examined rates of Symptom Validity Test (SVT) failure in active duty military service members with a history of mild-moderate TBI and its impact on gait speed. Setting: Intensive Outpatient Program at the National Intrepid Center of Excellence at Walter Reed National Military Medical Center. Participants: Participants were 84 active duty service members with a history of mild-moderate TBI classified as SVT pass (n = 49) or SVT fail (n = 35). Design: Retrospective study. Main Measures: Overground preferred and fast walking speed as well as Computer Assisted Rehabilitation Environment (CAREN) gait speed were recorded. Participants completed the Neurobehavioral Symptom Inventory and the Validity-10 was used to assign patients into the SVT pass and SVT fail groups. Gait speed metrics were compared across these groups and test operating characteristics were calculated. Results: Approximately 42% of the sample was classified into the SVT fail group. All 3 gait speed measures were significantly slower in the SVT fail group than in the SVT pass group (Ps < .001, ds = 0.60-0.80). Gait speed cutoffs for screeners or indicators of atypical reporting were identified. Conclusions: The potential for response bias is a critical area for the clinician to consider when conducting physical therapy evaluations. Participants in the SVT fail group had slower walking speed on all 3 measures assessed. Several useful cutoffs were identified to serve as screeners or indicators of SVT failure, though these preliminary findings have limitations and need to be replicated.

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mentioning

confidence: 99%

Overground and Virtual Reality Gait Speed Are Associated With Atypical Symptom Reporting in Active Duty Service Members With a History of Mild to Moderate Traumatic Brain Injury

Rosen

Delpy

Pape

et al. 2021

Journal of Head Trauma Rehabilitation

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Different shell, same shock

Popkirov

Wessely

Nicholson

et al. 2017

BMJ

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Clinical signs in functional (psychogenic) gait disorders: a brief survey

Sokol¹,

Espay²

2016

J Clin Mov Disord

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Clinical signs are critical in ascertaining the functional nature of a gait disorder. Four signs of gait impairment have been documented in the course of examining patients with clinically definite functional (psychogenic) movement disorders: “huffing and puffing” during standing and walking, manipulation-resistance dorsiflexion of the first toe, fixed plantar flexion and inversion, and marked discrepancy between ambulation with and without swivel chair assistance. While large studies are needed to ascertain their prevalence, sensitivity, and specificity, the identification of these signs may help elevate the diagnostic certainty of functional gait disorders.Electronic supplementary materialThe online version of this article (doi:10.1186/s40734-016-0031-1) contains supplementary material, which is available to authorized users.

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Shell Shock: Psychogenic Gait and Other Movement Disorders - A Film Review

Cited by 4 publications

References 23 publications

Overground and Virtual Reality Gait Speed Are Associated With Atypical Symptom Reporting in Active Duty Service Members With a History of Mild to Moderate Traumatic Brain Injury

Overground and Virtual Reality Gait Speed Are Associated With Atypical Symptom Reporting in Active Duty Service Members With a History of Mild to Moderate Traumatic Brain Injury

Different shell, same shock

Clinical signs in functional (psychogenic) gait disorders: a brief survey

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