Classification of gait disturbances: Distinguishing between continuous and episodic changes

Authors

  • Nir Giladi MD,

    Corresponding author
    1. Movement Disorders Unit, Department of Neurology, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel
    2. Department of Neurology, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
    3. Sagol School of Neuroscience, Tel-Aviv University, Tel-Aviv, Israel
    • Correspondence to: Prof. Nir Giladi, Department of Neurology, Tel-Aviv Sourasky Medical Center, 6 Weizmann Street, Tel Aviv, Israel 64239; e-mail: nirg@tlvmc.gov.il

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  • Fay B. Horak PhD, PT,

    1. Department of Neurology, Oregon Health and Science University, Portland, Oregon, USA
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  • Jeffrey M. Hausdorff PhD

    1. Movement Disorders Unit, Department of Neurology, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel
    2. Sagol School of Neuroscience, Tel-Aviv University, Tel-Aviv, Israel
    3. Department of Physical Therapy, Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel
    4. Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA
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  • Funding agencies: This work received support from the National Institutes on Aging, the National Center of Medical Rehabilitation Research, the European Commission, the Kinetics Foundation, and OHSU.

  • Relevant conflicts of interest/financial disclosures: Nothing to report.

  • Full financial disclosure and author roles may be found in the online version of this article.

ABSTRACT

The increased awareness of the importance of gait and postural control to quality of life and functional independence has led many research groups to study the pathophysiology, epidemiology, clinical, and therapeutic aspects of these motor functions. In recognition of the increased awareness of the significance of this topic, the Movement Disorders journal is devoting this entire issue to gait and postural control. Leading research groups provide critical reviews of the current knowledge and propose future directions for this evolving field.

The intensive work in this area throughout the world has created an urgent need for a unified language. Because gait and postural disturbances are so common, the clinical classification should be clear, straightforward, and simple to use. As an introduction to this special issue, we propose a new clinically based classification scheme that is organized according to the dominant observed disturbance, while taking into account the results of a basic neurological exam. The proposed classification differentiates between continuous and episodic gait disturbances because this subdivision has important ramifications from the functional, prognostic, and mechanistic perspectives.

We anticipate that research into gait and postural control will continue to flourish over the next decade as the search for new ways of promoting mobility and independence aims to keep up with the exponentially growing population of aging older adults. Hopefully, this new classification scheme and the articles focusing on gait and postural control in this special issue of the Movement Disorders journal will help to facilitate future investigations in this exciting, rapidly growing area. © 2013 International Parkinson and Movement Disorder Society

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