The impact of gait disorders on executive functions in neurological patients: A literature review

https://doi.org/10.21744/ijhms.v8n3.2404

Authors

  • Anna Chalkia Αssistant Professor at the International University of Greece, Department of Physiotherapy
  • Tsigaras Georgios Postdoctoral Researcher in Physiotherapy Department International University of Greece PhD Medical School (Aristotle University of Thessaloniki) MSc Pediatric Physiotherapy Pediatric Physiotherapist NDT-SPP-SI-FINE Professional(Neonatal-Pediatric)Centre for Developmental Pediatrics 'APOSTOLOS FOKAS' 1st Department of Padiatric (AUTH) Hippokratio General Hospital Academic Scholar in Physiotherapy Department International University of Greece
  • Poimenidis Onoufrios PT, PhDc, at the International University of Greece, Department of Physiotherapy
  • Gkiourtzis Nikolaos MD, MSc, PgDip, PhD (c) 4th Pediatric Dept. A.U.Th., Papageorgiou Hospital, Thessaloniki, Greece St. Luke's Hospital, Thessaloniki, Greece
  • Vasiliadis Diogenis Μedical student at the Aristotle University of Thessaloniki, Greece
  • Kariofyllis Mylonas Nurse, Nursing Science Master
  • Kallistratos A. Ilias Professor President of Physiotherapy Department Faculty of Health Sciences International Hellenic University Lab of of Basic and Applied Research in Physiotherapy Rehabilitation, Director Dept. Physiotherapy

Keywords:

Executive Functions, Gait Disorders, Neurological Patients

Abstract

This is a literature review covering the intricate and two-way association between gait disorders and executive functioning deficits in individuals with neurological disorders. The review begins by defining executive functions, followed by a discussion of its fundamental components (inhibition, working memory, cognitive flexibility), and finally, the neural foundation of EF is outlined, focusing on the frontal lobes and related brain networks. A typology of neurological gait disorders (e.g., Parkinsonian, hemiplegic, ataxic) is then described, which is then correlated with their respective etiologies. The cognitive-motor interference model of gait-executive functions interaction and the shared neural resource theories are explored as frameworks explaining the phenomenon, and the dual-task paradigm as a methodological instrument is considered specifically. In the review, the authors examined how this interaction manifests in neurological diseases, including Parkinson's, stroke, and multiple sclerosis, and noted the peculiarities and mechanisms in each instance. Lastly, the clinical implications of this interaction on everyday functioning, risk of falls, and quality of life are addressed, along with what they mean regarding rehabilitation approaches, with a particular focus on integrated motor-cognitive interventions, including dual-task training and novel technologies (e.g., exergaming, virtual reality). 

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References

Allali, G., Annweiler, C., Blumen, H. M., Callisaya, M. L., De Cock, A. M., Kressig, R.W & Beauchet, O. (2010). Gait and neurodegenerative disorders: A focus on Alzheimer's disease and related disorders. Neurodegenerative Disease Management, 1(1), 77-87.

Ardila, A. (2008). On the evolutionary origins of executive functions. Brain and cognition, 68(1), 92-99. https://doi.org/10.1016/j.bandc.2008.03.003

Axer, H., Axer, M., Sauer, H., Witte, O. W., & Hagemann, G. (2010). Falls and gait disorders in geriatric neurology. Clinical neurology and neurosurgery, 112(4), 265-274. https://doi.org/10.1016/j.clineuro.2009.12.015

Bae, M., & VanNostrand, M. (2025). Cognition and Measures of Physical Activity, Mobility, and Gait in Individuals With Multiple Sclerosis: A Systematic Review. Neurorehabilitation and Neural Repair, 15459683251335315.

Batara, R., Ardani, I. G. A. I., Wardani, I. A. K., Windiani, I. G. A. T., Adnyana, I. G. A. N. S., & Setiawati, Y. (2022). Psychogenic dysphagia in children, and the success of family-based treatment: Case report. International Journal of Health & Medical Sciences, 5(1), 163-168. https://doi.org/10.21744/ijhms.v5n1.1894

Carroll, D. J., & Simpson, A. (2022). The Development of Executive Function: Mechanisms of Change. Psychological Review, 129(5), 977–1006.

Cleveland Clinic. (n.d.-a). Executive Function. Retrieved from my.clevelandclinic.org. Link: https://my.clevelandclinic.org/health/articles/executive-function

Cleveland Clinic. (n.d.-b). Gait Disorders. Retrieved from my.clevelandclinic.org. Link: https://my.clevelandclinic.org/health/diseases/21092-gait-disorders

COAST Rehab. (n.d.). Gait Disorders. Retrieved from coastrehabnj.com. Link: https://coastrehabnj.com/physical-therapy-services/orthopedic/gait-disorders/

EBSCO Research Starters. (2024). Executive Function. Retrieved from ebsco.com. Link: https://www.ebsco.com/research-starters/social-sciences-and-humanities/executive-function

Ghasemi, Z., Khademi, M., Shaygannejad, V., & Eskandari, N. (2024). Comparing the effects of dual task and combined exercise training in water and on land on cognition, balance and gait in people with multiple sclerosis: A randomized clinical trial. Multiple Sclerosis and Related Disorders, 80, 105051.

Guo, Y., Wang, H., Zhang, D., Liu, T., & Wang, J. (2021). Dual-task training improves cognitive and walking functions in Parkinson's disease: A systematic review and meta-analysis. Frontiers in Aging Neuroscience, 13, 708011.

Hsu, P.-C., Lin, Y.-T., Lin, C.-H., Chang, K.-V., Wang, T.-G., & Chen, L.-C. (2022). Association between turning mobility and cognitive function in patients with chronic post-stroke. Journal of Clinical Medicine, 11(5), 1309.

Huber, S. K., Knols, R. H., Held, J. P., Betschart, M., Gartmann, S., Nauer, N., & de Bruin, E. D. (2025). PEMOCS: effects of a concept-guided, PErsonalized, MOtor-Cognitive exergame training on cognitive functions and gait in chronic Stroke—a randomized, controlled trial. Frontiers in Aging Neuroscience, 17, 1514594.

Kadrnka, S., Hildebrandt, H., Büssing, S., & Pust, G. (2025). Dual-task effects on gait and cognitive performance in persons with multiple sclerosis: A comparative study using wearable inertial sensors and the Paced Auditory Serial Addition Test. Frontiers in Neurology.

Loyola Medicine. (2025). Overview and Facts about Gait Disorders. Retrieved from loyolamedicine.org. Link: https://www.loyolamedicine.org/services/neurology-and-neurosurgery/conditions/movement-disorders/gait-disorders

Montalvan, V., Lee, J., Bueso, T., De Toledo, J., & Rivas, K. (2020). Neurological manifestations of COVID-19 and other coronavirus infections: a systematic review. Clinical neurology and neurosurgery, 194, 105921. https://doi.org/10.1016/j.clineuro.2020.105921

Montero?Odasso, M., Verghese, J., Beauchet, O., & Hausdorff, J. M. (2012). Gait and cognition: a complementary approach to understanding brain function and the risk of falling. Journal of the American Geriatrics Society, 60(11), 2127-2136.

Number Analytics. (n.d.). Revolutionizing Neurological Rehab: Dual-Task Training. Retrieved from numberanalytics.com. Link: https://www.numberanalytics.com/blog/revolutionizing-neurological-rehab-dual-task-training

Plummer-D'Amato, P., Altmann, L. J. P., Behrman, A. L., & Marsiske, M. (2013). Cognitive-motor interference during gait and balance in stroke: A systematic review. Gait & Posture, 38(4), 548-556.

Sharrack, B., Paling, D., Nair, K. P. S., & Mazzà, C. (Eds.). (n.d.). Wearable Sensors in the Evaluation of Gait and Balance in Neurological Disorders. MDPI.

Sheridan, P. L., Solomont, J., Kowall, N., & Hausdorff, J. M. (2003). The role of executive function and attention in gait. Movement Disorders, 18(8), 866-872.

Stanford Medicine 25. (n.d.). Gait Abnormalities. Retrieved from stanfordmedicine25.stanford.edu. Link: https://stanfordmedicine25.stanford.edu/the25/gait.html

Stasolla, F., Caffò, A. O., Perilli, V., & Boccasini, A. (2016). Motor-Cognitive Dual-Task Training for Individuals With Neurologic Disorders: A Systematic Review. American Journal of Physical Medicine & Rehabilitation, 95(7), 517-531.

UCSF Memory and Aging Center. (n.d.). Executive Functions. Retrieved from memory.ucsf.edu. Link: https://memory.ucsf.edu/brain-health/executive-functions

Wajda, D. A., & Sosnoff, J. J. (2015). A systematic review of dual-task walking in individuals with multiple sclerosis: implications for research and clinical practice. Multiple Sclerosis Journal, 21(11), 1366-1377.

Wikipedia contributors. (n.d.). Embodied cognition. In Wikipedia. Retrieved from en.wikipedia.org/wiki/Embodied_cognition. Link: https://en.wikipedia.org/wiki/Embodied_cognition

Published

2025-07-22

How to Cite

Chalkia, A., Tsigaras, G., Poimenidis, O., Gkiourtzis, N., Vasiliadis, D., Kariofyllis, M., & Kallistratos, I. (2025). The impact of gait disorders on executive functions in neurological patients: A literature review. International Journal of Health & Medical Sciences, 8(3), 39-54. https://doi.org/10.21744/ijhms.v8n3.2404