Journal Article

FZJ-2025-03243

http://join2-wiki.gsi.de/foswiki/pub/Main/Artwork/join2_logo100x88.png Instrument-supported gait analysis characterizes gait domain changes in patients with suspected normal pressure hydrocephalus

Semmler, C. (Corresponding author) ; Wunderle, V. ; Kuzu, T. D. ; Onur, O. A. ; Grefkes, C. ; Barbe, M. T. ; Fink, G. R.FZJ* ; Weiss-Blankenhorn, P.FZJ*

2025
BioMed Central [London]

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Please use a persistent id in citations: doi:10.1186/s42466-025-00394-z  doi:10.34734/FZJ-2025-03243

Abstract: AbstractBackground: 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.Keywords: Center of force; Center of pressure; Ground reaction force; Kinetics; iNPH.

Note: Open Access funding enabled and organized by Projekt DEAL. The Deutsche Forschungsgemeinschaft (DFG, German Research Foundation)—Project-ID 431549029—SFB 1451 funded this project. CG received additional funding from project GRK 2783. OO received consulting fees from Biogen and Lilly and lecture fees from Eisai, Boston Scientific, and Functional Neuromodulation. This work was also supported by a Marga and Walter Boll-Foundation grant to OO and GRF.

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Contributing Institute(s):

1. Kognitive Neurowissenschaften (INM-3)

Research Program(s):

1. 5251 - Multilevel Brain Organization and Variability (POF4-525) (POF4-525)
2. DFG project G:(GEPRIS)431549029 - SFB 1451: Schlüsselmechanismen normaler und krankheitsbedingt gestörter motorischer Kontrolle (431549029) (431549029)

Appears in the scientific report 2025

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