Useful outcome measures in INPH patients evaluation

Area of Science:

• Neurology
• Biomedical Engineering
• Geriatrics

Background:

• Idiopathic normal pressure hydrocephalus (INPH) presents with gait disturbance, cognitive decline, and urinary incontinence, often assessed with the Timed Up and Go (TUG) test.
• Current assessment methods for INPH may lack comprehensive sensitivity, necessitating improved diagnostic protocols.

Purpose of the Study:

• To evaluate the sensitivity of a combined clinical and instrumental assessment protocol for gait and balance in identifying INPH patients.
• To determine key spatio-temporal gait parameters for INPH assessment and their correlation with clinical measures.

Main Methods:

• Seventy INPH patients and 20 healthy subjects (HS) underwent balance assessments (Berg Balance Scale, Short Physical Performance Battery, TUG single and dual task) and instrumental gait analysis (GAITRite).
• Gait was assessed at normal speed, fast speed, and during a dual task, measuring various spatio-temporal parameters.

Main Results:

• INPH patients scored significantly lower on the Berg Balance Scale, Short Physical Performance Battery, and TUG dual task, but not the TUG single task.
• Instrumental gait analysis revealed significant differences in most spatio-temporal parameters between INPH patients and HS, except cadence.
• Significant correlations were found between clinical balance measures and instrumental gait parameters.

Conclusions:

• The dual-task TUG and GAITRite instrumental analysis show greater utility in recognizing INPH than the single-task TUG.
• Stride length, stride width, speed, and double support percentage are crucial spatio-temporal parameters for INPH assessment.
• Integrating clinical and instrumental evaluations is recommended for comprehensive INPH assessment and fall risk identification.