Posture and gait in the early course of schizophrenia

Abstract

While correlations between postural stability deficits and schizophrenia are well documented, information on dynamic motor alterations in schizophrenia are still scarce, and no data on their onset are available yet. Therefore, the aim of this study was i) to measure gait pattern(s) in patients with schizophrenia; ii) to identify posture and gait alterations which could potentially be used as a predictive clinical tool of the onset of the disorder. Body composition, posture and gait parameters were assessed in a group of 30 patients with schizophrenia and compared to 25 healthy subjects. Sway area was significantly higher in the schizophrenia group compared to controls regardless of whether the participants were in eyes open or eyes closed condition. Gait cadence and speed were significantly lower in patients with schizophrenia, while stride length was similar. We concluded that the combination of an increased sway area (independent from eye closure) and a gait cadence reduction-in the presence of normal gait speed and stride length-might be considered peculiar postural and gait profile characteristic of early schizophrenia.

Fig 1

Path length (panel A) and sway area (panel B) for healthy controls (CG, n = 25) and schizophrenia group (SG, OE n = 27, CE n = 28). OE bars represent data for open eyes condition and CE bars represent the closed eyes condition. One-way ANOVA and Tukey HSD Test for post-hoc comparisons were used to compare path length and sway area between CG and SG in both open and closed eyes conditions. Data were considered statistically significant if p-Value was less than 0.05. *p<0.05.

Fig 2

Cadence (panel A), gait speed (panel B) and percentage of stride length (% Stride Length, panel C) for healthy controls (CG, n = 24) and schizophrenia group (SG, n = 27). T-tests were performed between CG and SG for cadence and gait speed, one-way ANOVA for comparisons between left and right percentage of stride length between CG and SG. Data were considered statistically significant if p-Value was less than 0.05. **p<0.01.

Fig 3

Path length (panels A-C) and sway area (panels D-F) for healthy controls (CG, n = 25) and schizophrenia group (SG) divided by time from first hospitalization (early-term disease, ETD, n = 12; middle-term disease, MTD, OE n = 8, CE n = 9; late-term disease, LTD, n = 7). OE bars represent data for open eyes condition and CE bars represent the closed eyes condition. One-way ANOVA and Tukey HSD Test for post-hoc comparisons were used for path length and sway area comparisons between CG and ETD, MTD, and LTD in both open and closed eyes conditions. Data were considered statistically significant if p-Value was less than 0.05. *p<0.05 **p<0.01.

Fig 4

Cadence (panels A-C), gait speed (panels D-F) and percentage of stride length (% Stride Length, panels G-I) for healthy controls (CG, n = 24) and schizophrenia group (SG) divided by time from first hospitalization (early-term disease, ETD, n = 9; middle-term disease, MTD, n = 9; late-term disease, LTD, n = 9). T-tests were performed between CG and ETD, MTD, and LTD for cadence and gait speed; one-way ANOVA for comparisons between left and right percentage of stride length between CG and ETD, MTD, and LTD. Data were considered statistically significant if p-Value was less than 0.05. *p≤0.05, **p<0.01.