[Cerebrovascular disease and gait disorders: qualitative and quantitative analysis].
OBJECTIVE
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).


METHODS
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.


RESULTS
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).


CONCLUSIONS
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.
Domínguez
R O
RO
Fundación Argentina Contra las Enfermedades Neurológicas del Envejecimiento (FACENE), Buenos Aires, Argentina. dominguezraul@hotmail.com
Bartolomé
E L
EL
Serra
J A
JA
Marschoff
E R
ER
Famulari
A L
AL
D'Abbraccio
G L
GL
González
S E
SE
Bagg
E
E
D000368:Aged; D000369:Aged, 80 and over; D001921:Brain / Q000098:blood supply / Q000473:pathology; D002544:Cerebral Infarction / Q000150:complications* / Q000175:diagnosis; D003430:Cross-Sectional Studies; D005260:Female; D005684:Gait; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009069:Movement Disorders / Q000175:diagnosis / Q000209:etiology*; D009460:Neurologic Examination; D004856:Postural Balance; D011446:Prospective Studies; D012720:Severity of Illness Index