Gait control and executive dysfunction in early schizophrenia

Abstract

Dysexecutive functioning, which is described as an enduring core feature of schizophrenia, has been associated with gait disorders. However, few studies have reported gait disorders in schizophrenia patients. The objective of this study was to examine the association between executive dysfunction and gait performance in recent-onset schizophrenia patients using the dual task paradigm. Thirty-two subjects participated to the study: 17 with recent-onset schizophrenia and 15 healthy age-matched controls. Executive functions were evaluated using the Frontal Assessment Battery, Stroop and Trail-Making tests. Mean values and coefficients of variation (CV) of the temporal gait parameters while single tasking (just walking) and while dual tasking (walking and forward counting, walking and backward counting, walking and verbal fluency) were measured using the SMTEC(®)-footswitch system. We focused on the CV of stride time as this measure has been shown to be the most representative parameter of higher gait control. A strong effect of the stride time was found in the group factor for the verbal fluency dual-task when compared to controls (Cohen's d mean = 1.28 and CV = 1.05). The effect was lower in the other dual tasks, and insignificant in the single task of walking. This study shows that patients exhibit higher stride-to-stride variability while dual tasking than controls. It also shows a stronger impact of verbal fluency on gait regularity compared to the other dual tasks revealing a relationship between the executive dysfunction and gait modification. Those results are in line with the idea that schizophrenia implies not only cognitive but also motor functioning and coordination impairment.

Movement markers of schizophrenia: a detailed analysis of patients’ gait patterns

“…Like Putzhammer and colleagues [ 41 ], we identified a significantly decreased gait velocity in patients compared to controls, which can be ascribed to a shorter stride length, not to a decreased cadence. Similarly to Lallart and colleagues [ 40 ], who compared the stride-to-stride variability of patients and controls in a “walk alone” and in dual-task conditions and found significant differences in the dual-task conditions only, we did not find group differences concerning the variation of cadence in simple walking. An increased intraindividual variability in kinematic indices such as peak velocity and peak acceleration was also found by Jahn et al, who developed a device to analyse repetitive pronation/supination for subtle kinematic changes [ 70 , 71 ].…”

Fusing Sensor Paradigms to Acquire Chemical Information: An Integrative Role for Smart Biopolymeric Hydrogels

“…Potentially, advances in sensor technology can contribute to providing such real‐time objective measures of functional biomarkers . For instance, a common symptom of schizophrenia is disorganized or abnormal motor behavior which could be detected or even continuously monitored by wearable sensor systems . Additionally, sensors that analyze a patient's voice may be able to detect the monotone speech patterns that are sometimes associated with schizophrenia .…”

Gait Variability, Not Walking Speed, Is Related to Cognition in Adolescents With Multiple Sclerosis

“…Previous studies have also found that gait variability is associated with cognitive performance in elders 12 and people suffering from central neurologic damage. [13][14][15] As for people with multiple sclerosis, we recently reported on a sample of 355 individuals with multiple sclerosis without a history of falls, whose increased step time variability was significantly associated with poor global cognitive scores, specifically executive function and motor skills. 16 In a recent study sample of 191 people with multiple sclerosis, cognitive processing speed was found to be a significant predictor of step time/length variability.…”