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Instrument-supported gait analysis characterizes gait domain changes in patients with suspected normal pressure
Carolin Semmler1,2, Veronika Wunderle3,4, Taylan D Kuzu5,6
1Faculty of Medicine, University of Cologne, Cologne, Germany. carolin.semmler@uk-koeln.de.
Neurological Research and Practice
|June 16, 2025
Summary
Idiopathic Normal Pressure Hydrocephalus (iNPH) patients who improve gait velocity by over 20% after a spinal tap are identified as responders. Instrument-supported gait analysis offers a more comprehensive assessment of iNPH gait improvements.
Area of Science:
- Neurology
- Biomedical Engineering
- Gait Analysis
Background:
- Idiopathic Normal Pressure Hydrocephalus (iNPH) is a reversible cause of cognitive impairment, incontinence, and gait disturbances.
- Patients with iNPH exhibit characteristic slow, shuffling, wide-based gaits, with reduced gait velocity.
- Gait velocity improvement after a spinal tap test is a key indicator in iNPH management.
Purpose of the Study:
- To evaluate the 20% gait velocity improvement criterion from the 10m walk test for identifying iNPH responders.
- To assess the added value of instrument-supported gait analysis in characterizing iNPH patient responses.
Main Methods:
- 59 patients with suspected iNPH underwent a spinal tap test and gait analysis (10m walk test and instrument-supported).
- Responders were defined as those with >20% improvement in gait velocity post-spinal tap.
- Statistical analyses included chi-square tests, t-tests, Mann-Whitney-U tests, and repeated measure ANOVAs.
Main Results:
- Responders (n=20) showed significant improvements in gait pace compared to non-responders (n=39) in the 10m walk test.
- Instrument-supported gait analysis revealed additional improvements in variability, rhythm, postural control, and force exclusively in responders.
- Clinical parameters alone were insufficient for classifying responders and non-responders.
Conclusions:
- The 20% gait velocity improvement criterion is clinically useful for differentiating iNPH responders from non-responders.
- Instrument-supported gait analysis provides a more comprehensive characterization of gait disturbances than the 10m walk test alone.
- Further longitudinal studies are needed to fully elucidate the potential of instrument-supported gait analysis in iNPH.
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