Background – Functional Motor Disorders (FMDs) are characterized by impaired motor control in the absence of identifiable structural abnormalities, making their distinction from Organic Motor Disorders (OMDs) a persistent clinical challenge. Quantitative evaluation of gait and postural control may offer objective markers to characterize motor abnormalities and support the differential diagnosis between functional and organic conditions. This study aimed to characterize gait and postural performance in individuals with FMDs compared to those with OMDs and healthy controls (HCs), using dual-task and sensory manipulation paradigms, and to examine their relationship with psychometric variables. Methods – In this multicenter cross-sectional study, patients with clinically definite FMDs (n = 149), OMDs (n = 99), and HCs (n = 153) underwent standardized assessments of posture and gait under single- and dual-task conditions (both motor and cognitive), as well as with eyes open and closed. Spatiotemporal gait parameters, stabilometric measures, and dual-task effects were analyzed. Psychometric variables were also collected to explore their association with motor performance. Results – Compared to OMDs and HCs, individuals with FMDs exhibited significantly greater postural instability, an opposite response to dual-task conditions, and increased stride time variability (all p < 0.05). In this group, motor performance was significantly associated with anxiety, depression, and fatigue, whereas alexithymia was associated with poorer gait performance only in OMDs and HCs (p < 0.05). Discussion – In conclusion, FMDs display a distinct motor and behavioral profile, particularly in response to dual-task paradigms. Quantitative measures such as dual-task effect, sway area under eyes-closed conditions, and stride time variability (all p < 0.05) may represent promising markers for differentiating functional from organic motor disorders.
Quantitative analysis of posture and gait in the differential diagnosis of functional and organic motor disorders: a multicenter cross-sectional study / Russo, M., Erro, R., Ricciardi, C., Gandolfi, M., Sandri, A., Amboni, M., Sarasso, E., Gardoni, A., Basaia, S., Cuoco, S., Carotenuto, I., Vinciguerra, C., Botto, A., Romano, D.G., Di Vico, I.A., Fiorio, M., Camozzi, S., Pedrotti, G., Fratucello, A., Mansueto, G., et al.. - In: FRONTIERS IN BIOENGINEERING AND BIOTECHNOLOGY. - ISSN 2296-4185. - 14:(2026). [10.3389/fbioe.2026.1872332]
Quantitative analysis of posture and gait in the differential diagnosis of functional and organic motor disorders: a multicenter cross-sectional study
Gardoni A.;Basaia S.;Filippi M.;Agosta F.;
2026-01-01
Abstract
Background – Functional Motor Disorders (FMDs) are characterized by impaired motor control in the absence of identifiable structural abnormalities, making their distinction from Organic Motor Disorders (OMDs) a persistent clinical challenge. Quantitative evaluation of gait and postural control may offer objective markers to characterize motor abnormalities and support the differential diagnosis between functional and organic conditions. This study aimed to characterize gait and postural performance in individuals with FMDs compared to those with OMDs and healthy controls (HCs), using dual-task and sensory manipulation paradigms, and to examine their relationship with psychometric variables. Methods – In this multicenter cross-sectional study, patients with clinically definite FMDs (n = 149), OMDs (n = 99), and HCs (n = 153) underwent standardized assessments of posture and gait under single- and dual-task conditions (both motor and cognitive), as well as with eyes open and closed. Spatiotemporal gait parameters, stabilometric measures, and dual-task effects were analyzed. Psychometric variables were also collected to explore their association with motor performance. Results – Compared to OMDs and HCs, individuals with FMDs exhibited significantly greater postural instability, an opposite response to dual-task conditions, and increased stride time variability (all p < 0.05). In this group, motor performance was significantly associated with anxiety, depression, and fatigue, whereas alexithymia was associated with poorer gait performance only in OMDs and HCs (p < 0.05). Discussion – In conclusion, FMDs display a distinct motor and behavioral profile, particularly in response to dual-task paradigms. Quantitative measures such as dual-task effect, sway area under eyes-closed conditions, and stride time variability (all p < 0.05) may represent promising markers for differentiating functional from organic motor disorders.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
