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Background <p>Idiopathic Normal Pressure Hydrocephalus (iNPH) is a potentially reversible cause of cognitive impairment, urinary incontinence, and gait disturbances, which typically present with a characteristic slow, shuffling, and wide-based gait. Gait velocity, which is reduced relative to healthy controls, improves in iNPH patients following a spinal tap test. This study aimed at evaluating the criterion of a 20% gait velocity improvement in the 10&#xa0;m walk test to identify responders and non-responders in a cohort of patients with probable iNPH receiving a spinal tap test as well as the added value of instrument-supported gait analysis.</p> Methods <p>We assessed <i>pace</i>, <i>rhythm</i>, <i>variability</i>, <i>postural control</i>, and <i>force</i> in 59 patients with clinically suspected iNPH undergoing a spinal tap test, applying the 10&#xa0;m walk test and an instrument-supported gait analysis. The change in gait velocity assessed in the 10&#xa0;m walk test was used to differentiate patients with a positive response to the spinal tap (&gt; 20% improvement, responders) from those with no relevant response (&lt; 20% improvement, non-responders). Group differences were analyzed using chi-square tests, independent sample t-tests, Mann–Whitney-U tests and repeated measure ANOVAs.</p> Results <p>Unlike non-responders (n = 39), responders (n = 20) showed significant changes in the gait domain <i>pace</i> in the 10&#xa0;m walk test. Moreover, instrument-supported gait analyses revealed additional improvements in the gait domains <i>variability, rhythm, postural control</i> and <i>force</i> in responders only.</p> Interpretation <p>This study confirmed the clinical utility of the 20% gait velocity improvement criterion for differentiating responders and non-responders in a cohort of patients with mostly probable iNPH, in whom clinical parameters alone were insufficient for classification. Notably, instrument-supported gait analysis validated this criterion by providing a more comprehensive characterization of gait disturbances compared to the 10&#xa0;m walk test. However, further—especially longitudinal—studies are needed to reveal the full potential of the instrument-supported gait analysis in patients with (early/probable) iNPH.</p>

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Instrument-supported gait analysis characterizes gait domain changes in patients with suspected normal pressure hydrocephalus

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年6月16日

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  • Carolin Semmler,
  • Veronika Wunderle,
  • Taylan D. Kuzu,
  • Oezguer A. Onur,
  • Christian Grefkes,
  • Michael T. Barbe,
  • Gereon R. Fink,
  • Peter H. Weiss

摘要

Background

Idiopathic Normal Pressure Hydrocephalus (iNPH) is a potentially reversible cause of cognitive impairment, urinary incontinence, and gait disturbances, which typically present with a characteristic slow, shuffling, and wide-based gait. Gait velocity, which is reduced relative to healthy controls, improves in iNPH patients following a spinal tap test. This study aimed at evaluating the criterion of a 20% gait velocity improvement in the 10 m walk test to identify responders and non-responders in a cohort of patients with probable iNPH receiving a spinal tap test as well as the added value of instrument-supported gait analysis.

Methods

We assessed pace, rhythm, variability, postural control, and force in 59 patients with clinically suspected iNPH undergoing a spinal tap test, applying the 10 m walk test and an instrument-supported gait analysis. The change in gait velocity assessed in the 10 m walk test was used to differentiate patients with a positive response to the spinal tap (> 20% improvement, responders) from those with no relevant response (< 20% improvement, non-responders). Group differences were analyzed using chi-square tests, independent sample t-tests, Mann–Whitney-U tests and repeated measure ANOVAs.

Results

Unlike non-responders (n = 39), responders (n = 20) showed significant changes in the gait domain pace in the 10 m walk test. Moreover, instrument-supported gait analyses revealed additional improvements in the gait domains variability, rhythm, postural control and force in responders only.

Interpretation

This study confirmed the clinical utility of the 20% gait velocity improvement criterion for differentiating responders and non-responders in a cohort of patients with mostly probable iNPH, in whom clinical parameters alone were insufficient for classification. Notably, instrument-supported gait analysis validated this criterion by providing a more comprehensive characterization of gait disturbances compared to the 10 m walk test. However, further—especially longitudinal—studies are needed to reveal the full potential of the instrument-supported gait analysis in patients with (early/probable) iNPH.