Instrument-supported gait analysis characterizes gait domain changes in patients with suspected normal pressure hydrocephalus
Abstract 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...
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BMC
2025-06-01
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| Series: | Neurological Research and Practice |
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| Online Access: | https://doi.org/10.1186/s42466-025-00394-z |
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| author | Carolin Semmler Veronika Wunderle Taylan D. Kuzu Oezguer A. Onur Christian Grefkes Michael T. Barbe Gereon R. Fink Peter H. Weiss |
| author_facet | Carolin Semmler Veronika Wunderle Taylan D. Kuzu Oezguer A. Onur Christian Grefkes Michael T. Barbe Gereon R. Fink Peter H. Weiss |
| author_sort | Carolin Semmler |
| collection | DOAJ |
| description | Abstract 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. |
| format | Article |
| id | doaj-art-3ff49cd1cdf14b2696de8dc52c6d83f5 |
| institution | Kabale University |
| issn | 2524-3489 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | BMC |
| record_format | Article |
| series | Neurological Research and Practice |
| spelling | doaj-art-3ff49cd1cdf14b2696de8dc52c6d83f52025-08-20T03:42:09ZengBMCNeurological Research and Practice2524-34892025-06-017111110.1186/s42466-025-00394-zInstrument-supported gait analysis characterizes gait domain changes in patients with suspected normal pressure hydrocephalusCarolin Semmler0Veronika Wunderle1Taylan D. Kuzu2Oezguer A. Onur3Christian Grefkes4Michael T. Barbe5Gereon R. Fink6Peter H. Weiss7Faculty of Medicine, University of CologneFaculty of Medicine, University of CologneFaculty of Medicine, University of CologneFaculty of Medicine, University of CologneDepartment of Neurology, University Hospital, Goethe University FrankfurtFaculty of Medicine, University of CologneFaculty of Medicine, University of CologneFaculty of Medicine, University of CologneAbstract 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.https://doi.org/10.1186/s42466-025-00394-ziNPHCenter of forceCenter of pressureGround reaction forceKinetics |
| spellingShingle | Carolin Semmler Veronika Wunderle Taylan D. Kuzu Oezguer A. Onur Christian Grefkes Michael T. Barbe Gereon R. Fink Peter H. Weiss Instrument-supported gait analysis characterizes gait domain changes in patients with suspected normal pressure hydrocephalus Neurological Research and Practice iNPH Center of force Center of pressure Ground reaction force Kinetics |
| title | Instrument-supported gait analysis characterizes gait domain changes in patients with suspected normal pressure hydrocephalus |
| title_full | Instrument-supported gait analysis characterizes gait domain changes in patients with suspected normal pressure hydrocephalus |
| title_fullStr | Instrument-supported gait analysis characterizes gait domain changes in patients with suspected normal pressure hydrocephalus |
| title_full_unstemmed | Instrument-supported gait analysis characterizes gait domain changes in patients with suspected normal pressure hydrocephalus |
| title_short | Instrument-supported gait analysis characterizes gait domain changes in patients with suspected normal pressure hydrocephalus |
| title_sort | instrument supported gait analysis characterizes gait domain changes in patients with suspected normal pressure hydrocephalus |
| topic | iNPH Center of force Center of pressure Ground reaction force Kinetics |
| url | https://doi.org/10.1186/s42466-025-00394-z |
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