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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">actabiomedica</journal-id><journal-title-group><journal-title xml:lang="ru">Acta Biomedica Scientifica</journal-title><trans-title-group xml:lang="en"><trans-title>Acta Biomedica Scientifica</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2541-9420</issn><issn pub-type="epub">2587-9596</issn><publisher><publisher-name>Scientific Centre for Family Health and Human Reproduction Problems</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.29413/ABS.2023-8.1.17</article-id><article-id custom-type="elpub" pub-id-type="custom">actabiomedica-4000</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ПСИХОЛОГИЯ И ПСИХИАТРИЯ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>PSYCHOLOGY AND PSYCHIATRY</subject></subj-group></article-categories><title-group><article-title>Диагностика психогенных (функциональных) расстройств походки</article-title><trans-title-group xml:lang="en"><trans-title>Diagnosis of psychogenic (functional) gait disorders</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Савков</surname><given-names>В. С.</given-names></name><name name-style="western" xml:lang="en"><surname>Savkov</surname><given-names>V. S.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Савков Владимир Станиславович – кандидат медицинских наук, доцент кафедры медицинской экспертизы, </p><p>664049, г. Иркутск, Юбилейный, 100</p></bio><bio xml:lang="en"><p>Vladimir S. Savkov – Cand. Sc. (Med.), Associate Professor at the Department of Medical Examination, </p><p>Yubileyniy 100, Irkutsk 664049</p></bio><email xlink:type="simple">mr.savkov1955@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>Иркутская государственная медицинская академия последипломного образования –&#13;
филиал ФГБОУ ДПО «Российская медицинская академия непрерывного&#13;
профессионального образования» Минздрава России</institution></aff><aff xml:lang="en"><institution>Irkutsk State Medical Academy of Postgraduate Education – Branch Campus of the Russian Medical Academy of Continuing Professional Education</institution></aff></aff-alternatives><pub-date pub-type="collection"><year>2023</year></pub-date><pub-date pub-type="epub"><day>12</day><month>03</month><year>2023</year></pub-date><volume>8</volume><issue>1</issue><fpage>148</fpage><lpage>157</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Савков В.С., 2023</copyright-statement><copyright-year>2023</copyright-year><copyright-holder xml:lang="ru">Савков В.С.</copyright-holder><copyright-holder xml:lang="en">Savkov V.S.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.actabiomedica.ru/jour/article/view/4000">https://www.actabiomedica.ru/jour/article/view/4000</self-uri><abstract><p>Психогенные нарушения походки нередко встречаются у пациентов с неврологическими симптомами, которые необъяснимы с медицинской точки зрения. Психогенные расстройства позы и походки являются основным проявлением у 8–10  % пациентов с нарушениями психогенного движения. Они  создают серьёзные диагностические проблемы для медицинских работников. Однако клиницисты могут прийти к правильному диагнозу уже при первичном осмотре, если они знают и умеют выявлять «позитивные» клинические признаки, направленные одновременно на исключение органической патологии и подтверждение психогенного (функционального) характера неврологических расстройств. При функциональных нарушениях походки ходьба часто бывает странной и не соответствует ни одному из  обычных образцов, наблюдаемых при нарушениях неврологической походки. Они могут включать: астазию-абазию (неспособность стоять или ходить) при отсутствии неврологической патологии; нерентабельную походку на полусогнутых ногах; моноплегическую походку с подтаскиванием ноги, нередко с эквиноварусной установкой стопы; или напоминать «прогулку по льду», с небольшими осторожными шагами и фиксированной в голеностопном суставе лодыжкой. Вспомогательные обследования, такие как нейровизуализация и нейрофизиологические исследования, могут предоставлять дополнительную информацию, но не являются необходимыми для диагностики. </p></abstract><trans-abstract xml:lang="en"><p>Psychogenic gait is common in patients with medically unexplained neurological symptoms and provides significant challenges to healthcare providers. Clinicians may arrive at a correct diagnosis earlier if distinctive positive signs are identified and acknowledged. Psychogenic disorders of posture and gait are common and are the major manifestation in 8–10 % of patients with psychogenic movement disorders. Psychogenic movement disorders can present with varied phenomenology that may resemble organic movement disorders. The diagnosis is based on clinical evaluation with a supporting history and classic features on neurologic examination. In functional gait disorders, walking is often bizarre and does not conform to any of the usual patterns observed with neurologic gait disorders. Astasia-abasia, an inability to stand (astasia) or walk (abasia) in the absence of other neurologic abnormalities, was the term applied by investigators in the mid to late 19thcentury to describe certain patients with a frankly functional gait. Other descriptive terms include gaits that resemble walking on ice, walking a sticky surface, walking through water (bringing to mind excessive slowness), tightrope walking, habitual limping, and bizarre, robotic, knock-kneed, trepidant, anxious, and cautious gaits. Ancillary testing, such as imaging and neurophysiologic studies, can provide supplementary information but is not necessary for diagnosis. </p></trans-abstract><kwd-group xml:lang="ru"><kwd>психогенная походка</kwd><kwd>анализ походки</kwd><kwd>неврологический экзамен</kwd><kwd>позитивные признаки</kwd></kwd-group><kwd-group xml:lang="en"><kwd>psychogenic gait</kwd><kwd>neurological examination</kwd><kwd>gait analysis</kwd><kwd>positive signs</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Edwards MJ, Bhatia KP. Functional (psychogenic) movement disorders: Merging mind and brain. 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