Instrumented gait analysis for an objective pre-/postassessment of tap test in normal pressure hydrocephalus.
OBJECTIVE
To present an objective method to evaluate gait improvements after a tap test in idiopathic normal pressure hydrocephalus (INPH).


METHODS
Retrospective analysis of gait data.


METHODS
Public tertiary care center, day hospital. The gait analysis was performed before and 2 to 4 hours after the tap test.


METHODS
Participants included patients with INPH (n=60) and age- and sex-matched controls (n=50; used to obtain reference intervals). From an initial referred sample of 79 patients (N=79), we excluded those unable to walk without walking aids (n=9) and those with incomplete (pre-/posttap test) gait data (n=10). Thirteen out of 60 patients were shunted and then reappraised after 6 months.


METHODS
Not applicable.


METHODS
Mahalanobis distance from controls, before and after the tap test. Eleven gait parameters were combined in a single quantitative score. Walking velocity was also evaluated because it is frequently used in tap test assessment.


RESULTS
Patients were classified into 2 groups: tap test responders (n=22, 9 of them were shunted) and not suitable for shunt (n=38, 4 of them were shunted). In the tap test responders group, 9 out of 9 patients improved after shunt. In the not suitable for shunt group, 3 out of 4 patients did not improve. Gait velocity increased after the tap test in 53% of responders and in 37% of patients not suitable for shunt.


CONCLUSIONS
The new method is applicable to clinical practice and allows for selecting tap test responders in an objective way, quantifying the improvements. Our results suggest that gait velocity alone is not sufficient to reliably assess tap test effects.
Department of Electronics and Telecommunications, Politecnico di Torino, Torino, Italy. Electronic address: valentina.agostini@polito.it.
Valentina
V
Agostini
Department of Neuroscience, Università di Torino, Torino, Italy.
Michele
M
Lanotte
Physical Medicine and Rehabilitation Unit, University Hospital Città della Salute e della Scienza di Torino, Torino, Italy.
Marina
M
Carlone
Physical Medicine and Rehabilitation Unit, University Hospital Città della Salute e della Scienza di Torino, Torino, Italy.
Marcello
M
Campagnoli
Physical Medicine and Rehabilitation Unit, University Hospital Città della Salute e della Scienza di Torino, Torino, Italy.
Irene
I
Azzolin
Physical Medicine and Rehabilitation Unit, University Hospital Città della Salute e della Scienza di Torino, Torino, Italy.
Roberto
R
Scarafia
Physical Medicine and Rehabilitation Unit, University Hospital Città della Salute e della Scienza di Torino, Torino, Italy.
Giuseppe
G
Massazza
Department of Electronics and Telecommunications, Politecnico di Torino, Torino, Italy.
Marco
M
Knaflitz
D000368:Aged; D000369:Aged, 80 and over; D004185:Disability Evaluation; D005260:Female; D005684:Gait; D006801:Humans; D006850:Hydrocephalus, Normal Pressure / Q000534:rehabilitation*; D008297:Male; D008875:Middle Aged; D026741:Physical Therapy Modalities; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D016138:Walking
Hydrocephalus, normal pressure; Multivariate analysis; Rehabilitation; Spinal puncture; Ventriculoperitoneal shunt