Functional Gait Disorders: Clinical presentations, Phenotypes and Implications for treatment

Area of Science:

• Neurology
• Gait Analysis
• Rehabilitation Medicine

Background:

• Functional Gait Disorders (FGD) are a frequent manifestation of motor-Functional Neurological Disorders (motor-FND), impacting ambulation.
• FGD presents with diverse phenotypes like 'knee buckling' and 'astasia-abasia', often accompanied by motor and non-motor symptoms.
• Clinical signs in FGD can be inconsistent with structural neurological diseases.

Approach:

• A narrative review of existing literature on FGD was conducted.
• The review involved a systematic search of scientific databases, key texts, and citation tracking.

Key Points:

• FGD is a complex and disabling condition with varied presentations.
• Motor and non-motor symptoms, including pain and fatigue, contribute to the functional impairment and distress in FGD.
• While specific FGD treatment studies are limited, rehabilitation of motor-FND cohorts indicates improvements in walking.

Conclusions:

• The interplay between motor and non-motor symptoms in FGD requires further investigation, with non-motor symptoms potentially exacerbating the condition.
• Multidisciplinary rehabilitation is the recommended approach for FGD.
• Optimal components of multidisciplinary rehabilitation for FGD are yet to be determined.