[Cerebrovascular disease and gait disorders: qualitative and quantitative analysis]

Pyramidal gait impairment (GI) is a classical trait of cerebrovascular disease (CVD). To developed a method to quantify prospectively and transversely GI and disequilibrium, to be applied in the screening of pyramidal and non-pyramidal syndromes associated to different ethiological subtypes of CVD; using an Index of Gait and Equilibrium (IGE).

In constructing IGE, we used 14 equally weighted semiological variables: 6 measure balance, 6 gait, 1 sensitive abnormalities and 1 falls. Two neurologists separately examined each subject in the same day and repeating the evaluation after a week. Data analyses included Kruskal Wallis, chi 2, Spearman correlations and Principal Components.

IGE was used in 90 subjects, 43 males, with a mean age of 70.6 years. 3 groups of people were formed: 1. CVD (A, 21 with silent vascular lesions diagnosed by imaging; B, 17 with vascular dementia; C, 21 with stroke); 2. 13 subjects with cautious gait, not associated to any disease; and 3. 18 normal control subjects (age 60-80 years). GI in the non-pyramidal syndrome were significantly related with small vessels disease (chi 2 = 16.37, dof = 1, p < 0.001).

GI in CVD, pyramidal and non-pyramidal syndromes were equally frequent. Increased values of IGE caused by cautious gait in youngest non-stroke patients suggested high probability of silent CVD and significant association with small vessels disease. This preliminary assessment of IGE showed a reproducible and reliable tool for objectification and quantification of gait disorders.