title: Investigation and clinical applications of muscle strength change in cerebrospinal fluid tap test in cases of idiopathic normal pressure hydrocephalus: A retrospective study.
abstract: The cerebrospinal fluid tap test (CSFTT) is widely used to diagnose idiopathic normal pressure hydrocephalus (iNPH) and predict the therapeutic effectiveness of shunting. However, the ability to walk cannot be quantified for patients who are unable to walk. Therefore, we examined whether the iNPH diagnostic aid is possible using dynamometry, even for patients who are unable to walk. In this study, 45 patients underwent grip strength assessment, quadriceps strength assessment, 10-m walk test, and 3-m Timed Up and Go test before and after CSFTT. Our investigation of physical functions indicated that the CSFTT-positive group demonstrated significant improvements in grip and bilateral quadriceps muscle strength. The results of the receiver operating characteristic analysis indicated that leg muscle strength measurement reliability was high and that the area under the curve was 0.754-0.811. Our investigation of the clinically effective cutoff point for the rate of change indicated that it was 13.6% for right quadriceps muscle strength and 15.3% for left quadriceps muscle strength. Comparing CSFTT results in cases of iNPH with the observed rate of change in muscle strength can aid in the diagnosis of iNPH.
authors.affiliation: Department of Rehabilitation, Nara Prefecture General Medical Center, Nara, Japan. Electronic address: lupin111113@yahoo.co.jp.
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Matsuoka
authors.affiliation: Department of Neurosurgery, Nara Prefecture General Medical Center, Nara, Japan.
authors.forename: Jun-Ichi
authors.initials: JI
authors.lastname: Iida
authors.affiliation: Department of Neurology, Nara Prefecture General Medical Center, Nara, Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Kawahara
authors.affiliation: Department of Neurosurgery, Nara Prefecture General Medical Center, Nara, Japan.
authors.forename: Yoshitomo
authors.initials: Y
authors.lastname: Uchiyama
mesh_terms: D000368:Aged; D019540:Area Under Curve; D005260:Female; D006801:Humans; D006850:Hydrocephalus, Normal Pressure / Q000175:diagnosis* / Q000503:physiopathology*; D007866:Leg / Q000503:physiopathology; D008297:Male; D053580:Muscle Strength / Q000502:physiology*; D053581:Muscle Strength Dynamometer; D018482:Muscle, Skeletal / Q000503:physiopathology; D012372:ROC Curve; D015203:Reproducibility of Results; D012189:Retrospective Studies; D013129:Spinal Puncture / Q000379:methods*; D000070857:Walk Test
keywords: Cerebrospinal fluid tap test (CSFTT); Hand-held dynamometer (HHD); Muscle strength; Normal pressure hydrocephalus (iNPH); Ventriculoperitoneal shunt (VP shunt)