Abstract
INTRODUCTION: Peripheral demyelinating neuropathies impair gait and increase fall risk, particularly under cognitively demanding conditions. While gait disturbances in chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) and Charcot-Marie-Tooth disease type 1A (CMT1A) are well documented, their differential responses to cognitive dual-tasking remain poorly understood. METHODS: In this prospective study, 62 patients (31 CIDP, 31 CMT1A) performed 10-m barefoot walking trials under three conditions: natural walking, low dual-task (answering factual questions), and high dual-task (introspective questions about illness impact). Gait parameters, including speed, stride length, stride time, foot and heel clearance, were measured using a motion capture system. Group, condition, and interaction effects were analyzed using linear mixed-effects models. RESULTS: Both groups showed significant reductions in gait speed and stride length under dual-task conditions. Compared to CMT1A, CIDP patients exhibited more pronounced slowing and increased stride time, especially during high dual-tasking. Heel clearance decreased significantly in CIDP, with a group × condition interaction, while CMT1A patients maintained more stable gait patterns. Foot clearance at peak swing declined in both groups without intergroup differences. DISCUSSION: These results suggest that CIDP patients adopt a more cautious gait under cognitive load, reflecting reduced automatism and adaptability. In contrast, CMT1A patients appear to benefit from long-term compensatory strategies developed over the disease course. Moreover, the CIDP patients decreased their heel clearance during dual-task, increasing the fall risk. CONCLUSION: Dual-task gait analysis reveals distinct adaptations in hereditary and acquired neuropathies. Parameters such as heel clearance and stride time may serve as functional markers to guide diagnosis and rehabilitation.