Article

Individuals with conversion disorder have neurologic symptoms that are not
identified by an underlying organic cause. Often the symptoms manifest as gait
disturbances. The modified gait abnormality rating scale (GARS-M) may be useful
for quantifying gait abnormalities in these individuals.
The purpose of this
study was to examine the reliability, responsiveness and concurrent validity of
GARS-M scores in individuals with conversion disorder. Data from 27 individuals
who completed a rehabilitation program were included in this study. Pre- and
post-intervention videos were obtained and walking speed was measured. Five
examiners independently evaluated gait performance according to the GARS-M
criteria. Inter- and intrarater reliability of GARS-M scores were estimated with
intraclass correlation coefficients (ICCs). Responsiveness was estimated with the
minimum detectable change (MDC). Pre- to post-treatment changes in GARS-M scores
were analyzed with a dependent t-test. The correlation between GARS-M scores and
walking speed was analyzed to assess concurrent validity. GARS-M scores were
quantified with good-to-excellent inter- (ICC = 0.878) and intrarater reliability
(ICC = 0.989). The MDC was 2 points. Mean GARS-M scores decreased from 7 +/- 5 at
baseline to 1 +/- 2 at discharge (t26 = 7.411, p < 0.001) and 85% of patients
improved beyond the MDC. Furthermore, GARS-M scores and walking speed
measurements were moderately correlated (r = -0.582, p = 0.004), indicating that
the GARS-M has acceptable concurrent validity. Our findings provide evidence that
the GARS-M scores are reliable, valid and responsive for quantifying gait
abnormalities in patients with conversion disorder. GARS-M scores provide
objective measures upon which treatment effects can be assessed.
CI - Copyright (c) 2014 Elsevier B.V. All rights reserved.

Langue : ANGLAIS