title: Psychogenic gait disorder: a randomized controlled trial of physical rehabilitation with one-year follow-up.
abstract: OBJECTIVE
  Psychogenic gait disorder, defined as loss of ability to walk without neurological aetiologies, has poor rehabilitation options that are well documented. Left untreated these patients have substantial and long-lasting dysfunction. The present study examined the effect of a 3-week inpatient rehabilitation programme compared with a waiting list control condition, and whether eventual gains were maintained at 1-month and 1-year follow-up.
  
  
  METHODS
  A cross-over design evaluated the effect of treatment, and a carry-over effect was considered as a long-lasting treatment effect. Treatment consisted of adapted physical activity within a cognitive behavioural framework, and focused on offering an alternative explanation of symptoms, positively reinforcing normal gait and not reinforcing dysfunction.
  
  
  METHODS
  A total of 60 patients were recruited from neurological departments and were randomly assigned to immediate treatment (intervention) or treatment after 4 weeks (controls).
  
  
  RESULTS
  Cross-over design revealed that the mean difference between treatment vs no treatment was 8.4 Functional Independence Measure units (p < 0.001, 95% confidence interval 5.2-11.7), and 6.9 Functional Mobility Scale units (p < 0.001, 95% confidence interval 5.5-8.3). Patients significantly improved their ability to walk and their quality of life after inpatient rehabilitation compared with the untreated control group. The improvements in gait were sustained at 1-month and 1-year follow-up.
  
  
  CONCLUSIONS
  Substantial and lasting improvement can be achieved by inpatient rehabilitation of patients with psychogenic gait, and the gains are maintained during follow-up.
authors.affiliation: Vestfold Hospital Trust, Clinic physical medicine and rehabilitation, NO-3101 Tønsberg, Norway. Anika.Jordbru@siv.no, Anika.Jordbru@rehabilitering.net.
authors.forename: Anika Aakerøy
authors.initials: AA
authors.lastname: Jordbru
authors.forename: Liv Marit
authors.initials: LM
authors.lastname: Smedstad
authors.forename: Ole
authors.initials: O
authors.lastname: Klungsøyr
authors.forename: Egil Wilhelm
authors.initials: EW
authors.lastname: Martinsen
mesh_terms: D000293:Adolescent; D000328:Adult; D018592:Cross-Over Studies; D005260:Female; D005500:Follow-Up Studies; D020235:Gait Apraxia / Q000523:psychology* / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D013997:Time Factors; D016138:Walking; D055815:Young Adult