TY - JOUR
T1 - Objective assessment of gait in normal-pressure hydrocephalus
AU - Williams, Michael A.
AU - Thomas, George
AU - De Lateur, Barbara
AU - Imteyaz, Hejab
AU - Rose, J. Gregory
AU - Shore, Wendy S.
AU - Kharkar, Siddharth
AU - Rigamonti, Daniele
PY - 2008/1
Y1 - 2008/1
N2 - OBJECTIVES: Gait abnormalities are an early clinical symptom in normal pressure hydrocephalus (NPH), and subjective improvement in gait after temporary removal of CSF is often used to decide to perform shunt surgery. We investigated objective measures to compare gait before and after CSF drainage and shunt surgery. DESIGN: Twenty patients and nine controls were studied. Quantitative gait measures were obtained at baseline, after 3 days of controlled CSF drainage, and after shunt surgery. Decision to perform surgery was based on response to drainage, and patients were assigned to shunted or unshunted groups for comparison. RESULTS: There was no improvement after CSF drainage in the unshunted group (n = 4). In the shunted group (n = 15) velocity, double-support time, and cadence improved significantly after drainage, and improved further after shunt surgery. The degree of improvement after drainage significantly correlated to the degree of improvement postshunt for velocity, double-support time, cadence, and stride length. CONCLUSIONS: There are significant, quantifiable changes in gait after CSF drainage that correspond to improvement after shunt surgery for patients with NPH. Use of objective gait assessment may improve the process of identifying these candidates when response to CSF removal is used as a supplemental prognostic test for shunt surgery.
AB - OBJECTIVES: Gait abnormalities are an early clinical symptom in normal pressure hydrocephalus (NPH), and subjective improvement in gait after temporary removal of CSF is often used to decide to perform shunt surgery. We investigated objective measures to compare gait before and after CSF drainage and shunt surgery. DESIGN: Twenty patients and nine controls were studied. Quantitative gait measures were obtained at baseline, after 3 days of controlled CSF drainage, and after shunt surgery. Decision to perform surgery was based on response to drainage, and patients were assigned to shunted or unshunted groups for comparison. RESULTS: There was no improvement after CSF drainage in the unshunted group (n = 4). In the shunted group (n = 15) velocity, double-support time, and cadence improved significantly after drainage, and improved further after shunt surgery. The degree of improvement after drainage significantly correlated to the degree of improvement postshunt for velocity, double-support time, cadence, and stride length. CONCLUSIONS: There are significant, quantifiable changes in gait after CSF drainage that correspond to improvement after shunt surgery for patients with NPH. Use of objective gait assessment may improve the process of identifying these candidates when response to CSF removal is used as a supplemental prognostic test for shunt surgery.
KW - Diagnosis
KW - Gait
KW - Hydrocephalus Shunts
KW - Normal-Pressure Hydrocephalus
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U2 - 10.1097/PHM.0b013e31815b6461
DO - 10.1097/PHM.0b013e31815b6461
M3 - Article
C2 - 17993991
AN - SCOPUS:37549019629
SN - 0894-9115
VL - 87
SP - 39
EP - 45
JO - American Journal of Physical Medicine and Rehabilitation
JF - American Journal of Physical Medicine and Rehabilitation
IS - 1
ER -