Gait characteristics in idiopathic normal pressure hydrocephalus: A controlled study using an inertial sensor system.

<h4>Background</h4>Gait disturbance is the most pronounced symptom in idiopathic normal pressure hydrocephalus (iNPH). Some gait parameters have been previously described, but an in-depth description of the gait pattern is lacking. The aim was to quantitatively evaluate gait in iNPH pati...

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Main Authors: Johanna Rydja, Petra Pohl, Andreas Eleftheriou, Fredrik Lundin
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2025-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0317901
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author Johanna Rydja
Petra Pohl
Andreas Eleftheriou
Fredrik Lundin
author_facet Johanna Rydja
Petra Pohl
Andreas Eleftheriou
Fredrik Lundin
author_sort Johanna Rydja
collection DOAJ
description <h4>Background</h4>Gait disturbance is the most pronounced symptom in idiopathic normal pressure hydrocephalus (iNPH). Some gait parameters have been previously described, but an in-depth description of the gait pattern is lacking. The aim was to quantitatively evaluate gait in iNPH patients before and after shunt surgery and compare it to healthy individuals (HI), and correlate it with functional tests preoperatively.<h4>Methods</h4>In total, 47 patients and 42 HI were included. The patients were assessed with the iNPH scale (total, gait and balance domain scores were analyzed), the timed up and go test (TUG) and an inertial sensor gait analysis system, RehaGait®, pre- and postoperatively. The HI were assessed with TUG and RehaGait®. Gait variables were: stride length, stride duration, velocity, cadence, variability, stance, swing, single support, double support, step height, hip, knee and ankle joint angles.<h4>Results</h4>Compared to HI, the main differences in the gait variables were: decreased stride length (p < 0.01), velocity (p < 0.01), swing time (p < 0.01), single support (p < 0.01), hip flexion (p < 0.01), heel strike angle (p < 0.01) and toe-off angle (p < 0.01). Step height was normalized postoperatively; all other variables remained significantly worse than the HI. There were strong correlations between stride length, velocity, heel strike angle, and toe-off angle and the functional gait tests, but no correlations for any variable and the balance domain score.<h4>Conclusions</h4>The patients walked with reduced hip flexion, heel strike angle and toe-off angle, and had shorter strides, decreased velocity, and increased time for swing and single support, compared to HI. Step height was the only gait variable normalized after shunt surgery. Ankle joint kinematics correlated strongly with the results in functional gait tests. More research is warranted about how gait speed affects other gait variables in iNPH.<h4>Trial registration</h4>ClinicalTrials.gov NCT04795089.
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spelling doaj-art-89c7f3b1dbeb4d71a1808fcfbdd0267c2025-08-20T03:21:47ZengPublic Library of Science (PLoS)PLoS ONE1932-62032025-01-01202e031790110.1371/journal.pone.0317901Gait characteristics in idiopathic normal pressure hydrocephalus: A controlled study using an inertial sensor system.Johanna RydjaPetra PohlAndreas EleftheriouFredrik Lundin<h4>Background</h4>Gait disturbance is the most pronounced symptom in idiopathic normal pressure hydrocephalus (iNPH). Some gait parameters have been previously described, but an in-depth description of the gait pattern is lacking. The aim was to quantitatively evaluate gait in iNPH patients before and after shunt surgery and compare it to healthy individuals (HI), and correlate it with functional tests preoperatively.<h4>Methods</h4>In total, 47 patients and 42 HI were included. The patients were assessed with the iNPH scale (total, gait and balance domain scores were analyzed), the timed up and go test (TUG) and an inertial sensor gait analysis system, RehaGait®, pre- and postoperatively. The HI were assessed with TUG and RehaGait®. Gait variables were: stride length, stride duration, velocity, cadence, variability, stance, swing, single support, double support, step height, hip, knee and ankle joint angles.<h4>Results</h4>Compared to HI, the main differences in the gait variables were: decreased stride length (p < 0.01), velocity (p < 0.01), swing time (p < 0.01), single support (p < 0.01), hip flexion (p < 0.01), heel strike angle (p < 0.01) and toe-off angle (p < 0.01). Step height was normalized postoperatively; all other variables remained significantly worse than the HI. There were strong correlations between stride length, velocity, heel strike angle, and toe-off angle and the functional gait tests, but no correlations for any variable and the balance domain score.<h4>Conclusions</h4>The patients walked with reduced hip flexion, heel strike angle and toe-off angle, and had shorter strides, decreased velocity, and increased time for swing and single support, compared to HI. Step height was the only gait variable normalized after shunt surgery. Ankle joint kinematics correlated strongly with the results in functional gait tests. More research is warranted about how gait speed affects other gait variables in iNPH.<h4>Trial registration</h4>ClinicalTrials.gov NCT04795089.https://doi.org/10.1371/journal.pone.0317901
spellingShingle Johanna Rydja
Petra Pohl
Andreas Eleftheriou
Fredrik Lundin
Gait characteristics in idiopathic normal pressure hydrocephalus: A controlled study using an inertial sensor system.
PLoS ONE
title Gait characteristics in idiopathic normal pressure hydrocephalus: A controlled study using an inertial sensor system.
title_full Gait characteristics in idiopathic normal pressure hydrocephalus: A controlled study using an inertial sensor system.
title_fullStr Gait characteristics in idiopathic normal pressure hydrocephalus: A controlled study using an inertial sensor system.
title_full_unstemmed Gait characteristics in idiopathic normal pressure hydrocephalus: A controlled study using an inertial sensor system.
title_short Gait characteristics in idiopathic normal pressure hydrocephalus: A controlled study using an inertial sensor system.
title_sort gait characteristics in idiopathic normal pressure hydrocephalus a controlled study using an inertial sensor system
url https://doi.org/10.1371/journal.pone.0317901
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AT petrapohl gaitcharacteristicsinidiopathicnormalpressurehydrocephalusacontrolledstudyusinganinertialsensorsystem
AT andreaseleftheriou gaitcharacteristicsinidiopathicnormalpressurehydrocephalusacontrolledstudyusinganinertialsensorsystem
AT fredriklundin gaitcharacteristicsinidiopathicnormalpressurehydrocephalusacontrolledstudyusinganinertialsensorsystem