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

Abstract

BackgroundGait 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.MethodsIn 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.ResultsCompared to HI, the main differences in the gait variables were: decreased stride length (p ConclusionsThe 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.Trial registrationClinicalTrials.gov NCT04795089.