Diagnostic Performance of the “Huffing and Puffing” Sign in Functional (Psychogenic) Movement Disorders
Year: 2014
Type: article
Study design: Observational Study
Abstract: OBJECTIVE: To determine the diagnostic value of effort-associated behaviors ("huffing and puffing" spectrum) in patients with psychogenic movement disorders. METHODS: Three blinded clinicians rated presence, severity, and duration of effort-associated features during standing and walking tasks on edited videos of 131 patients with psychogenic gait disorders and 37 patients with organic gait disorders. RESULTS: Huffing, grunting, grimacing, and breath holding were the most common effort-associated behaviors in patients with psychogenic gait disorders, with a combined prevalence of 44% and disproportionate to the severity of gait impairment compared to organic gait disorders. The presence of "huffing and puffing"-type behaviors yielded a relatively low sensitivity but high specificity for the diagnosis of psychogenic movement disorders, increasing the odds of diagnosis 13-fold (95%, CI: 4.2-43.8) compared to organic gait disorders. CONCLUSIONS: Demonstration of effort-associated behaviors during standing and walking strongly supports the psychogenic nature of disorders when gait is involved.
DOI: 10.1002/mdc3.12102
Language: English
Subfield: Psychiatry and Mental health
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W276079853