Technological Advances for Gait and Balance in Normal Pressure Hydrocephalus: A Systematic Review
Alessandro Zampogna1,2, Martina Patera1, Marco Falletti1
1Department of Human Neurosciences, Sapienza University of Rome, 00185 Rome, Italy.
Bioengineering (Basel, Switzerland)
|February 26, 2025
Summary
Normal pressure hydrocephalus (NPH) impairs gait and balance. Instrumental assessments show significant differences in NPH patients, aiding early detection, but longitudinal data is needed for prognosis.
Area of Science:
- Neurology
- Biomechanical Engineering
- Rehabilitation Medicine
Background:
- Normal pressure hydrocephalus (NPH) is a treatable neurological condition characterized by cognitive decline, gait disturbance, and urinary incontinence.
- Gait and balance impairments are early and prominent symptoms of NPH, offering potential for early diagnosis.
- Instrumental gait and balance assessments can provide objective measures crucial for NPH evaluation.
Purpose of the Study:
- To systematically review and synthesize findings from studies using instrumental assessments of gait and balance in Normal pressure hydrocephalus (NPH).
- To evaluate the methodologies and quality of existing research on instrumental gait and balance analysis in NPH.
- To identify key kinematic differences in gait and balance between NPH patients and control groups.
Main Methods:
- A systematic literature search was conducted on PubMed adhering to PRISMA guidelines, covering studies from 2000 to 2024.
- Included studies utilized laboratory instruments (e.g., force plates, motion capture, inertial sensors) to assess gait and balance in NPH patients.
- A quality assessment was performed on the selected studies to evaluate their internal, statistical, and external validity.
Main Results:
- The review encompasses 41 gait studies and 17 balance studies, predominantly observational and cross-sectional.
- Significant kinematic differences were observed in gait and balance parameters of NPH patients compared to healthy controls and other neurological conditions.
- Various instrumental tools, including pressure-sensitive platforms, optoelectronic systems, and wearable sensors, were employed.
Conclusions:
- Instrumental gait and balance assessments reveal significant kinematic alterations in NPH patients.
- These objective measures hold promise for early detection, diagnosis, and understanding NPH pathophysiology.
- The lack of longitudinal data currently limits the definitive use of these measures for prognostic purposes in NPH.
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