Home physical exercise program: analysis of the impact on the clinical evolution of patients with normal pressure hydrocephalus

Abstract

Objective: To present a program of home physical exercises for patients with normal pressure hydrocephalus (NPH) and to evaluate adherence, acceptance and applicability; to verify possible changes in patients with NPH in the home physical exercise program, comparing patients with, and without, a ventriculoperitoneal shunt, regarding gait, quality of life, activities of daily living, static and dynamic balance and its impact on the risks of falling. Methods: This was a controlled clinical trial, with assessments in three moments (0, 10 and 18 weeks) at the home, from October 2015 to November 2017. Fifty-two patients (30 women and 22 men) participated in the study. Results: There was a statistically significant improvement with 10 weeks of home physical exercises for the groups with and without ventriculoperitoneal shunt, respectively, in the sub-items: activities of daily living p = 0.032*, p = 0.003*; static balance p < 0.001*, p < 0.001*; functional capacity p < 0.001*, p = 0.027*; and dynamic balance and gait p = 0.009*, p < 0.001*. There was no statistically significant difference for the subitems: quality of life p = 0.695, p = 1.000; and NPH grading scale p = 0.695, p = 1.000, respectively. Conclusion: The developed program of home physical exercise was easily applied and there was good acceptance by most patients with NPH included in the research. There was a statistically significant improvement with the 10 weeks of home physical exercises in the sub-items: activities of daily living, static balance and functional capacity, for both groups. In the sub-item dynamic balance and gait, there was a statistically significant improvement for both groups, but with a higher score for the group with a ventriculoperitoneal shunt. There was no statistically significant difference for the sub-items: quality of life, NPH grading scale and risk of falls, based on the Berg scale.

Diagnosis and treatment for normal pressure hydrocephalus: From biomarkers identification to outcome improvement with combination therapy

“…Consequently, patients not only can get into physical therapy program sooner but also can raise the chance of using their lower limbs to walk actively, practice squat to sustain flexibility of joints and function of core muscle, even be able to conduct a higher level of difficult balance and coordination movement to gradually extend time and area of mobility. It is important to keep home physical exercise which has significantly better performance in activities of daily living, static balance, functional capacity, dynamic balance, and gait for patients with iNPH [ 45 ].…”

Physical exercise and goal attainment after shunt surgery in idiopathic normal pressure hydrocephalus: a randomised clinical trial

“…Rehabilitation in iNPH is emphasised to be an important factor to improve patients’ functions [ 13 , 14 ]. A recently published non-randomised clinical trial evaluating home exercise in iNPH concluded that home exercise was easy to implement and accepted by the patients [ 15 ]. However, no randomised clinical trial has explored the effectiveness of rehabilitation in iNPH.…”