Computerized gait analysis with inertial sensor in the management of idiopathic normal pressure hydrocephalus

Panciani, Pier Paolo; Migliorati, Karol; Muratori, Andrea; Gelmini, Marco; Padovani, Alessandro; Fontanella, Marco Maria

doi:10.23736/s1973-9087.18.04949-3

Cited by 16 publications

(20 citation statements)

References 23 publications

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“…Previous studies have reported that the gait features used in determining the diagnosis of iNPH are not specific for identifying individuals who responded to tap tests ( 17 ). However, some quantitative studies have shown contrary results ( 4 , 18 – 20 ). Our study provides evidence that gait and balance parameters are useful for quantifying changes after ELD in patients with iNPH.…”

Section: Discussionmentioning

confidence: 94%

“…Winter et al ( 22 ) studied changes in the biomechanical walking pattern in healthy elderly individuals and found that double-limb support is a stabilizing factor during a normal gait cycle. Panciani et al ( 18 ) observed a significant reduction in the duration of double support, which was obviously improved after the CSFTT. In the current study, we observed an increased percentage of double support to stabilize inefficient gait control in responders before the ELD, and the duration of double support was improved after the ELD.…”

Section: Discussionmentioning

confidence: 96%

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Quantitative Evaluation of Gait Changes Using APDM Inertial Sensors After the External Lumbar Drain in Patients With Idiopathic Normal Pressure Hydrocephalus

Yao

et al. 2021

Front. Neurol.

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Objectives: Gait and balance disturbances are common symptoms of idiopathic normal pressure hydrocephalus (iNPH). This study aimed to quantitatively evaluate gait and balance parameters after external lumbar drainage (ELD) using APDM inertial sensors.Methods: Two-minute walkway tests were performed in 36 patients with suspected iNPH and 20 healthy controls. A total of 36 patients underwent ELD. According to clinical outcomes, 20 patients were defined as responders, and the other 16 as non-responders. The gait parameters were documented, and the corresponding differences between responders and non-responders were calculated.Results: When compared with healthy controls, patients with suspected iNPH exhibited decreased cadence, reduced gait speed, a higher percentage of double support, decreased elevation at mid-swing, reduced foot strike angle, shorter stride length, difficulty in turning, and impaired balance functions. After the ELD, all these manifestations, except elevation at mid-swing and balance functions, were significantly improved in responders. The change of Z-score absolute value in the six parameters, except for foot strike angle, was >1. No significant improvement was observed in non-responders.Conclusion: APDM inertial sensors are useful for the quantitative assessment of gait impairment in patients with iNPH, which may be a valuable tool for identifying candidates that are suitable for shunting operations.

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Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 96%

Quantitative Evaluation of Gait Changes Using APDM Inertial Sensors After the External Lumbar Drain in Patients With Idiopathic Normal Pressure Hydrocephalus

Yao

et al. 2021

Front. Neurol.

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“…In this study, out of 151 patients with suspected hydrocephalus from brain imaging and at least one symptom of the classical triad, 76 were A B C D Fig. 2 Radar plots of the progression of median values of cadence, stride length, total time, total steps, double support, and gait speed for a p-iNPH on TUG, b v-iNPH on TUG, c p-iNPH on 18 mW and d v-iNPH on 18 mW from baseline to T72 h. Distances are normalized with respect to baseline (blue lines) and normative values (green dot lines) derived for TUG from [18,38]; for 18 mW from [33]. Red plots refer to the p-iNPH group, yellow plots to the v-iNPH group.…”

Section: Discussionmentioning

confidence: 99%

“…Among these, Stolze et al in a study involving 10 iNPH patients, reported gait speed and stride length as the most responsive parameters in a pre-vs. 24 h post-CSF-TT comparison, whereas cadence and balance remained unaffected [17]. More recently, Panciani et al compared gait performances on 52 iNPH patients pre vs. few hours post-CSF-TT finding improvements in gait speed, stride length and double support duration [18]. Another study compared performances on a timed-up and go test (TUG) pre vs. 24 h post-CSF-TT revealing significant improvements in the sit-to-stand transition, walking time, and the number of steps employed to turn [19].…”

Section: Introductionmentioning

confidence: 99%

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The effects of cerebrospinal fluid tap-test on idiopathic normal pressure hydrocephalus: an inertial sensors based assessment

Ferrari

Milletti

Giannini

et al. 2020

J NeuroEngineering Rehabil

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Background: Gait disturbances are typical of persons with idiopathic normal pressure hydrocephalus (iNPH) without signs distinctive from other neurodegenerative and vascular conditions. Cerebrospinal fluid tap-test (CSF-TT) is expected to improve the motor performance of iNPH patients and is a prognostic indicator in their surgical management. This observational prospective study aims to determine which spatio-temporal gait parameter(s), measured during instrumented motor tests, and clinical scale(s) may provide a relevant contribution in the evaluation of motor performance pre vs. post CSF-TT on iNPH patients with and without important vascular encephalopathy. Methods: Seventy-six patients (20 with an associated vascular encephalopathy) were assessed before, and 24 and 72 h after the CSF-TT by a timed up and go test (TUG) and an 18 m walking test (18 mW) instrumented using inertial sensors. Tinetti Gait, Tinetti Balance, Gait Status Scale, and Grading Scale were fulfilled before and 72 h after the CSF-TT. Stride length, cadence and total time were selected as the outcome measures. Statistical models with mixed effects were implemented to determine the relevant contribution to response variables of each quantitative gait parameter and clinical scales. Results and conclusion: From baseline to 72 h post CSF-TT patients improved significantly by increasing cadence in 18 mW and TUG (on average of 1.7 and 2.4 strides/min respectively) and stride length in 18 mW (on average of 3.1 cm). A significant reduction of gait apraxia was reflected by modifications in double support duration and in coordination index. Tinetti Gait, Tinetti Balance and Gait Status Scale were able to explain part of the variability of response variables not covered by instrumental data, especially in TUG. Grading Scale revealed the highest affinity with TUG total time and cadence when considering clinical scales alone. Patients with iNPH and an associated vascular encephalopathy showed worst performances compared to pure iNPH but without statistical significance. Gait improvement following CSF-TT was comparable in the two groups. Overall these results suggest that, in order to augment CSF-TT accuracy, is key to assess the gait pattern by analyzing the main spatiotemporal parameters and set post evaluation at 72 h. Trial registration: Approved by ethics committee: CE 14131 23/02/2015.

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Gait Analysis in Idiopathic Normal Pressure Hydrocephalus: A Meta‐Analysis

Passaretti

Maranzano

Bluett³

et al. 2023

Movement Disord Clin Pract

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BackgroundGait analysis objectively quantifies gait impairment in idiopathic normal pressure hydrocephalus (iNPH), may improve diagnosis and evaluation for surgical candidacy.ObjectivesThis meta‐analysis aims to understand which objective gait parameters improve after tap‐test (TT) and CSF shunt surgery (CSS), also comparing responders (R) with non‐responders (NR) and to assess if gait restores within the range of healthy controls after procedures.MethodsStudies enrolling iNPH with at least one instrumented gait measure were selected. Three time points of gait assessment were defined: PRE, POST‐TT, and POST‐CSS. Gait velocity, cadence, step length, stride length, and double limb support time were evaluated. Patients were categorized based on responsiveness to CSF diversion procedures.ResultsSeventeen studies including 527 patients were selected. iNPH improved significantly in almost all gait parameters POST‐TT, and to a greater extent POST‐CSS. Gait parameters consistently discriminated iNPH from healthy controls. Despite the aforementioned improvements, iNPH's gait did not completely normalize after CSF diversion procedures. Meta‐regression analysis also revealed that TT's effect on gait velocity plateaus after 24‐48 hours and returns to baseline in 90‐100 hours.ConclusionsGait analysis is a reliable quantitative instrument to assess gait impairment in iNPH, demarking a net differentiation from healthy controls, according to the notion that the iNPH CSF dynamic alteration also leads to an irreversible damage. Specific gait parameters improve among TT‐R, providing an opportunity to select patients that will respond to CSS. Future studies validating a standardized reporting method including criteria of responsiveness, specific gait parameters, and timeframe of assessment are needed.This article is protected by copyright. All rights reserved.

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Computerized gait analysis with inertial sensor in the management of idiopathic normal pressure hydrocephalus

Abstract: Identification of a GD pattern for iNPH, especially in rehabilitation, may be useful for recognizing patients who are candidates for surgery, thus avoiding permanent disability.

Cited by 16 publications

References 23 publications

Quantitative Evaluation of Gait Changes Using APDM Inertial Sensors After the External Lumbar Drain in Patients With Idiopathic Normal Pressure Hydrocephalus

Quantitative Evaluation of Gait Changes Using APDM Inertial Sensors After the External Lumbar Drain in Patients With Idiopathic Normal Pressure Hydrocephalus

The effects of cerebrospinal fluid tap-test on idiopathic normal pressure hydrocephalus: an inertial sensors based assessment

Gait Analysis in Idiopathic Normal Pressure Hydrocephalus: A Meta‐Analysis

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