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Updated: Aug 4, 2026
Asymmetric Walkway: A Novel Behavioral Assay for Studying Asymmetric Locomotion
Published on: January 15, 2016
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.
Background:
Functional gait disorder (FGD) is a subtype of functional neurological disorder (FND) characterized by abnormal walking patterns. Long-term symptom progression and factors influencing gait changes in FGD remain poorly understood.
Objectives:
To investigate longitudinal changes in gait and associated symptoms over 12 months in individuals with FGD and examine whether changes in specific symptoms are associated with changes in gait.
Methods:
Individuals with FND and altered gait completed an online survey at baseline and at 3-, 6-, and 12-month follow-up points. The survey collected data on symptom severity, gait changes, and standardised outcome measures. Analyses included descriptive statistics, linear mixed models, Kruskal-Wallis tests, and Spearman's rank correlations.
Results:
Of 156 baseline respondents, 65 completed the 12-month follow-up. Sixteen (28.5 %) reported worsening gait, 17 (30.4 %) no change, 13 (23.2 %) improvement, and 10 (17.8 %) fluctuating gait. Linear mixed-model analyses showed no significant within-subject changes in motor or non-motor symptom severity from baseline to 12 months. Greater baseline functional seizure severity was strongly associated with poorer gait outcomes at 12 months (Rₛ = -0.750, p < 0.001, n = 17). Higher muscle rigidity severity at 12 months was also strongly associated with worse gait (Rₛ = -0.604, p < 0.001, n = 30).
Conclusion:
This study provides insights into the natural course of functional gait disorder over time, based on participant self-report, revealing heterogeneous trajectories. Exploratory analyses found that functional seizure and muscle rigidity severity were associated with gait decline.
