Gait Alterations in the Prediction of Metabolic Syndrome in Patients With Schizophrenia: A Pilot Study With PODOSmart ® Insoles

Dimitris Efthymiou; Dimitrios X Zekakos; Evangelia Papatriantafyllou; Efthimis Ziagkas; Alexandros N Petrelis; Emilia Vassilopoulou

doi:10.3389/fpsyt.2022.756600

Gait Alterations in the Prediction of Metabolic Syndrome in Patients With Schizophrenia: A Pilot Study With PODOSmart ® Insoles

Front Psychiatry. 2022 Jan 27:13:756600. doi: 10.3389/fpsyt.2022.756600. eCollection 2022.

Authors

Dimitris Efthymiou¹, Dimitrios X Zekakos², Evangelia Papatriantafyllou³, Efthimis Ziagkas⁴, Alexandros N Petrelis², Emilia Vassilopoulou³

Affiliations

¹ Division of Neurosciences, Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece.
² Digitsole SAS, Nancy, France.
³ Department of Nutritional Sciences and Dietetics, International Hellenic University, Thessaloniki, Greece.
⁴ Laboratory of Motor Behaviour, Aristotle University of Thessaloniki, Thessaloniki, Greece.

Abstract

Background: Second-generation antipsychotics (APs) are associated with metabolic syndrome (MetS), characterized by abnormal pro-inflammatory cytokine production and oxidative stress due to the reduced antioxidant systems, and neurological effects, including mobility impairment. This pilot study investigated relationships between inflammatory-metabolic biomarkers, MetS and gait alterations in patients with psychosis treated with APs.

Methods: Patients with psychosis treated with APs, 20 with MetS (MPS group) and 20 without MetS (PS group) were studied, usinganthropometric data, blood measurements and gait analysis performed with the PODOSmart ® gait analysis device.

Results and discussion: The MPS group had significantly higher mean body mass index (BMI) and arterial blood pressure (BP) than the PS group. PODOSmart ® gait analysis recorded significant differences between groups in pronation-supination at Heel Off (HO), gaitline HO and gaitline Toe Off (TO). Multifactorial elastic net regression models demonstrated significant association with MetS of inflammatory markers, specific AP2 treatment, gender, age; BMI; BP and smoking (accuracy λ = 0.08), and in relation to gait parameters (accuracy λ = 0.750), the three pronation- supination variables, i.e., at HO, flat foot in (AP2 related) and TO, and propulsion speed. The gait parameters were at the edges of the model, thus indicating a more significant role of these parameters compared to the other clinical variables. Early diagnosis of MetS in patients with schizophrenia via identification of gait alterations can be a screening measure for serious cardiovascular complications related to psychosis and APs, to enable timely dietary intervention that can control the pro-inflammatory state and reduce oxidative stress.

Keywords: PODOSmart ®; antipsychotics; gait analysis; gaitline; inflammation; metabolic syndrome; speed; weight.