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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Main Authors: Carolin Semmler, Veronika Wunderle, Taylan D. Kuzu, Oezguer A. Onur, Christian Grefkes, Michael T. Barbe, Gereon R. Fink, Peter H. Weiss
Format: Article
Language:English
Published: BMC 2025-06-01
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.
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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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