Quantitative evaluation of changes in gait after extended cerebrospinal fluid drainage for normal pressure hydrocephalus

Yang, Felix; Hickman, Thu-Trang T.; Tinl, Megan; Iracheta, Christine; Chen, Grace; Flynn, Patricia M.; Shuman, Matthew E.; Johnson, Tatyana A.; Rice, Rebecca R.; Rice, Isaac M.; Wiemann, Robert; Johnson, Mark D.

doi:10.1016/j.jocn.2015.11.013

Cited by 12 publications

(7 citation statements)

References 4 publications

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“…For example, <5 improvement on iTUG score after the tap test is considered less improvement, ≥5 to <10 is slightly improvement, ≥10 to <20 is sufficient improvement, and ≥20 is excellent improvement. Previously reported instrumentations for evaluating gait disturbance and changes in patients with iNPH were too expensive and complicated for universal clinical use [15, 23-27]. In comparison with these methods, our iTUG score can be easily measured without the need for considerable amounts of time and money.…”

Section: Discussionmentioning

confidence: 99%

Quantitative Evaluation of Gait Disturbance on an Instrumented Timed Up-and-go Test

Yamada¹,

Aoyagi²,

Yamamoto³

et al. 2019

Aging and disease

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Although the 3-m timed up-and-go test (TUG) is reliable for evaluating mobility, TUG time is insufficient to evaluate mild gait disturbance; we, therefore aimed to investigate other measurements with instrumented TUG (iTUG) using a free smartphone application. Our inclusion criterion in this study is only that participants can walk without any assistance. This study included three heterogeneous groups; patients who underwent a tap test or shunt surgery, 29 inpatients hospitalized for other reasons, and 87 day-care users. After the tap test, 28 were diagnosed with tap-positive idiopathic normal-pressure hydrocephalus (iNPH) and 8 were diagnosed with tap-negative. Additionally, 18 patients were assessed iTUG before and after shunt surgery. During iTUG, time and 3-dimensional (3D) acceleration were automatically recorded every 0.01 s. A volume of the 95% confidence ellipsoid (95%CE) of all plots for 3D acceleration was calculated. Additionally, an iTUG score was defined as (95%CE volume) 0.8 / 1.9 - 1.9 × (time) + 60. The measurement reliability was evaluated using intraclass correlations and Bland-Altman plots. The participants with mild gait disturbance who accomplished within 13.5 s on the iTUG time had the 95%CE volumes for 3D acceleration of ≥70 m3/s6 and iTUG scores of ≥50. The mean iTUG time was shortened and the mean 95%CE volumes and iTUG scores were increased after the tap test among 28 patients with tap-positive iNPH and after shunt surgery among 18 patients with definite iNPH. Conversely, the mean iTUG score among 8 patients with tap-negative was decreased after the tap test. The intraclass correlations for the time, 95%CE volume and iTUG score were 0.97, 0.80 and 0.90, respectively. Not only the iTUG time but also the 95%CE volume was important for evaluating mobility. Therefore, the novel iTUG score consisting both is useful for the quantitative assessment of mobility.

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Section: Discussionmentioning

confidence: 99%

Quantitative Evaluation of Gait Disturbance on an Instrumented Timed Up-and-go Test

Yamada¹,

Aoyagi²,

Yamamoto³

et al. 2019

Aging and disease

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“…Five trials (218 patients underwent shunt) of Timed Up and Go Test in normal pressure hydrocephalus (Table 1) were available for pooling. 30,31,33,39,41 The overall estimate of Sn was 0.89 ( Figure 3), that is, an improvement in Timed Up and Go Test after cerebrospinal fluid drainage detects 89% of normal pressure hydrocephalus patients who will respond favorably to a shunt procedure. The overall estimate of Sp was 0.63 ( Figure 3), that is, improvements less than the prespecified criteria in Timed Up and Go Test after cerebrospinal fluid drainage detects 63% of normal pressure hydrocephalus patients who will not respond favorably to a shunt procedure.…”

Section: Timed Up and Go Testmentioning

confidence: 99%

“…Figure 1 illustrates the flow of articles through the review. Of the 29 articles included in our study, 22 (75.9%) used prospective designs 6,7,[15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34] while 7 (24.1%) used retrospective designs [35][36][37][38][39][40][41] (Supplementary Table 1).…”

Section: Study Selectionmentioning

confidence: 99%

“…All trials included in this review used physical and cognitive measures before and after cerebrospinal fluid drainage procedure to predict responses to shunt procedure in normal pressure hydrocephalus (Supplementary Table 1). Studies used a variety of assessment tools for the measure of physical function which included the following: 18-meter walk test (18-mWT; n = 7), 15,18,19,21,23,26,35 Timed Up and Go Test (n = 7), 29,[31][32][33][39][40][41] scoring of video-recordings of gait (n = 5), 6,8,22,24,37 25-meter walk test (n = 2), 6,20 Dutch normal pressure hydrocephalus gait scale (n = 3), 27,28,40 idiopathic normal pressure hydrocephalus (iNPH) grading scale (n = 3), 26,29,31 and Tinetti balance tests (n = 2). 33,40 Three studies used their own individual grading scales, 22,24,35 while three studies used other walking tests, such as the 5-meter walk and stair-climbing tests 20 and the GAITRite portable walkway, with analysis of spatial and temporal parameters of gait.…”

Section: Study Characteristicsmentioning

confidence: 99%

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A systematic review of the diagnostic utility of simple tests of change after trial removal of cerebrospinal fluid in adults with normal pressure hydrocephalus

et al. 2018

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“…The latest generation of IMUs are indeed wireless, small, lightweight, cost-effective and operating in real-time, therefore allowing the plugand-play execution of gait analysis tests in the times of clinical routine [15]. Besides, the use of apps for mobile devices allows us to run the tests in any environment and to have detailed reports right after their executions [15,16].…”

Section: Introductionmentioning

confidence: 99%

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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Quantitative evaluation of changes in gait after extended cerebrospinal fluid drainage for normal pressure hydrocephalus

Cited by 12 publications

References 4 publications

Quantitative Evaluation of Gait Disturbance on an Instrumented Timed Up-and-go Test

Quantitative Evaluation of Gait Disturbance on an Instrumented Timed Up-and-go Test

A systematic review of the diagnostic utility of simple tests of change after trial removal of cerebrospinal fluid in adults with normal pressure hydrocephalus

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

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