Psychogenic gait disorder: a randomized controlled trial of physical rehabilitation with one-year follow-up

J Rehabil Med. 2014 Feb;46(2):181-7. doi: 10.2340/16501977-1246.


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.

Design: 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.

Patients: 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.

Conclusion: Substantial and lasting improvement can be achieved by inpatient rehabilitation of patients with psychogenic gait, and the gains are maintained during follow-up.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Adult
  • Cross-Over Studies
  • Female
  • Follow-Up Studies
  • Gait Apraxia / psychology*
  • Gait Apraxia / rehabilitation*
  • Humans
  • Male
  • Middle Aged
  • Time Factors
  • Walking
  • Young Adult