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Longitudinal gait changes in functional neurological disorder: A 12-month prospective study
Sara Issak1, Glenn Nielsen2, Natalie A Fini3
1Department of Physiotherapy, Melbourne School of Health Sciences, The University of Melbourne, Level 7, Alan Gilbert Building, 161 Barry St, Carlton, Victoria 3053, Australia; Department of Physiotherapy, Epworth Healthcare, 888 Toorak Road Camberwell, Victoria 3124, Australia.
Journal of Psychosomatic Research
|October 31, 2025
Summary
Functional gait disorder (FGD) has varied long-term outcomes. Functional seizure and muscle rigidity severity correlate with worsening gait in individuals with FGD.
Area of Science:
- Neurology
- Gait Analysis
- Functional Neurological Disorders
Background:
- Functional gait disorder (FGD) is a subtype of functional neurological disorder (FND).
- FGD is characterized by abnormal walking patterns.
- Long-term progression and influencing factors of FGD gait changes are poorly understood.
Purpose of the Study:
- To investigate longitudinal gait changes over 12 months in individuals with FGD.
- To examine associations between changes in specific symptoms and gait changes.
Main Methods:
- Online surveys administered at baseline and 3-, 6-, 12-month follow-ups.
- Collected data on symptom severity, gait changes, and standardized outcome measures.
- Utilized descriptive statistics, linear mixed models, Kruskal-Wallis tests, and Spearman's rank correlations.
Main Results:
- Out of 156 baseline respondents, 65 completed the 12-month follow-up.
- Gait trajectories were heterogeneous: 28.5% worsening, 30.4% no change, 23.2% improvement, 17.8% fluctuating.
- No significant within-subject changes in motor/non-motor symptom severity observed.
- Greater baseline functional seizure severity (R=-0.750) and higher 12-month muscle rigidity severity (R=-0.604) were associated with poorer gait outcomes.
Conclusions:
- Participant self-reports reveal heterogeneous natural trajectories for FGD over 12 months.
- Functional seizure severity and muscle rigidity are associated with gait decline in FGD.
- Further research is needed to understand FGD progression and identify predictive factors.
Keywords:
Functional gait disorderFunctional neurological disorderLongitudinal studyPrognosisSymptoms
