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

Objectives: Psychogenic gait is common in patients with medically unexplained neurological symptoms and provides significant challenges to healthcare providers. Clinicians may arrive at a correct diagnosis earlier if distinctive positive signs are identified and acknowledged. This study aims to offer a tool for identifying patterns of psychogenic gait based on positive signs in clinical settings. Design: A video study with assessment of inter-rater reliability. Patients: Thirty consecutive patients diagnosed with psychogenic gait disturbance by neurologist before inclusion. Methods: In a gait laboratory patients were first categorized into 3 categories by 2 of the authors. Another rater was given both oral and written guidance and the next 3 raters only written information. Inter-rater reliability was estimated between the first and the 4 other ratings. Results: The main finding was that psychogenic gait could be categorized into 3 categories. These were: limping of 1 leg, limping of 2 legs; and truncal imbalance. Inter-rater reliability of the classification in the various categories was high. Conclusion:The present study provides the clinician with 3 well-described patterns to examine for if a psychogenic gait disorder is suspected, thereby simplifying detection.

Functional neurological disorder (FND) is a common and disabling disorder, often misunderstood by clinicians. Although viewed sceptically by some, FND is a diagnosis that can be made accurately, based on positive clinical signs, with clinical features that have remained stable for over 100 years. Despite some progress in the last decade, people with FND continue to suffer subtle and overt forms of discrimination by clinicians, researchers and the public. There is abundant evidence that disorders perceived as primarily affecting women are neglected in healthcare and medical research, and the course of FND mirrors this neglect. We outline the reasons why FND is a feminist issue, incorporating historical and contemporary clinical, research and social perspectives. We call for parity for FND in medical education, research and clinical service development so that people affected by FND can receive the care they need.

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AimTo explore leaders’ perceptions and experiences of facilitators and barriers for successful workplace inclusion of immigrants, unemployed youths, and people who are outside the labor market due to health issues.MethodsSemi-structured individual interviews with 16 leaders who actively engaged in inclusion work, representing different occupations, were conducted. Systematic Text Condensation was used to structure the analysis.ResultsThe participating leaders emphasized that job match, including their perception of workers’ motivation, respect for workplace policies, and the availability of appropriate accommodation at the workplace, facilitated work inclusion. An active public support system providing professional and financial support to workers and leaders was also an important facilitating factor. The leaders emphasized that their perception of workers’ lack of motivation for the job was the most important barrier in their own hiring and inclusion engagement. Successful inclusion depended on all workers acknowledging responsibility for and contributing to an inclusive work environment. Being open and willing to discuss challenges was an important part of making the inclusion work. In addition, leadership qualities, such as empathy, patience, and a non-judgmental attitude, appeared as a hallmark among these leaders who actively engaged in inclusion work.ConclusionWorkplace inclusion of this population of marginalized people was facilitated by job match, mutual respect, commitment, and trust, as well as financial and practical support from the public support system. Leaders’ inclusion practices were furthermore affected by personal attitudes and perceptions of social responsibility. Even so, successful workplace inclusion was presented as a two-way street. Leaders have the main responsibility in initiating a respectful and trusting relationship, but both the worker and the leader needs to contribute to make the relationship thrive.