Are we supererestimating gait assessments of patients with idiopathic normal-pressure hydrocephalus? 2019

Fernanda Colella, and Danielli Speciali, and Milena Bernal, and Wagner de Godoy, and Fabiano Politti, and Paulo Roberto Garcia Lucareli
Department of Rehabilitation Science, Human Motion Analysis Laboratory, Universidade Nove de Julho, São Paulo, Brazil.

Idiopathic normal pressure hydrocephalus (iNPH) is a syndrome characterized by a triad composed of cognitive alteration, urinary incontinence, and gait impairment associated with ventricular enlargement and normal cerebrospinal fluid pressure. Gait impairment is among the earliest symptoms; however, the reliability of the evaluation is not well-established and no consensus has been reaching regarding variables that should be analyzed and which parameters should be considered to accurately assess post-intervention improvement. Are the degree of repeatability, standard error of measurement, and minimum detectable change considered to detect changes in gait variables in iNPH patients? A total of 84 iNPH patients with a mean age of 77.1 (±6.4) years were analyzed. Gait deviation index (GDI), speed, cadence, cycle time, stride length, single support, and first and second double support were chosen as the variables to be analyzed. Statistical analysis was performed by an independent evaluator, with gait repeatability assessed by the intraclass correlation coefficient (ICC) and the standard error of measure (SEM). ICC values were 0.76-0.85 with excellent repeatability, while SEM demonstrated that the variables with best repeatability were the GDI (mean, 4.94; 95% confidence interval (CI), 4.63-5.43), representing a 7.65% mean relative error of the measurement (mean, 0.05 m; 95% CI, 0.05-0.06), and stride length (mean 0.05 m; 95% CI, 0.05-0.06), with a 7.69% mean relative error. We concluded that GDI and stride length were the variables with the best repeatability and lower variability in the gait of iNPH patients.

UI MeSH Term Description Entries
D008297 Male Males
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D006850 Hydrocephalus, Normal Pressure A form of compensated hydrocephalus characterized clinically by a slowly progressive gait disorder (see GAIT DISORDERS, NEUROLOGIC), progressive intellectual decline, and URINARY INCONTINENCE. Spinal fluid pressure tends to be in the high normal range. This condition may result from processes which interfere with the absorption of CSF including SUBARACHNOID HEMORRHAGE, chronic MENINGITIS, and other conditions. (From Adams et al., Principles of Neurology, 6th ed, pp631-3) Hakim Syndrome,Normal Pressure Hydrocephalus,Hakim's Syndrome,Hydrocephalus, Normal-Pressure,NPH (Normal Pressure Hydrocephalus),Hakim Syndromes,Hakim's Syndromes,Hakims Syndrome,NPHs (Normal Pressure Hydrocephalus),Syndrome, Hakim,Syndrome, Hakim's,Syndromes, Hakim,Syndromes, Hakim's
D000072797 Walking Speed The rate at which steps are made while walking. Gait Speed,Walking Pace,Gait Speeds,Pace, Walking,Paces, Walking,Speed, Gait,Speed, Walking,Speeds, Gait,Speeds, Walking,Walking Paces,Walking Speeds
D000077107 Gait Analysis Determination of the level of functional limitation that may be due to pathology, and evaluating rehabilitative intervention of the way in which the body moves from one point to another. Most often, this is done by walking. Analysis, Gait,Gait Analyses
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly
D015203 Reproducibility of Results The statistical reproducibility of measurements (often in a clinical context), including the testing of instrumentation or techniques to obtain reproducible results. The concept includes reproducibility of physiological measurements, which may be used to develop rules to assess probability or prognosis, or response to a stimulus; reproducibility of occurrence of a condition; and reproducibility of experimental results. Reliability and Validity,Reliability of Result,Reproducibility Of Result,Reproducibility of Finding,Validity of Result,Validity of Results,Face Validity,Reliability (Epidemiology),Reliability of Results,Reproducibility of Findings,Test-Retest Reliability,Validity (Epidemiology),Finding Reproducibilities,Finding Reproducibility,Of Result, Reproducibility,Of Results, Reproducibility,Reliabilities, Test-Retest,Reliability, Test-Retest,Result Reliabilities,Result Reliability,Result Validities,Result Validity,Result, Reproducibility Of,Results, Reproducibility Of,Test Retest Reliability,Validity and Reliability,Validity, Face
D020233 Gait Disorders, Neurologic Gait abnormalities that are a manifestation of nervous system dysfunction. These conditions may be caused by a wide variety of disorders which affect motor control, sensory feedback, and muscle strength including: CENTRAL NERVOUS SYSTEM DISEASES; PERIPHERAL NERVOUS SYSTEM DISEASES; NEUROMUSCULAR DISEASES; or MUSCULAR DISEASES. Ambulation Disorders, Neurologic,Charcot Gait,Charcot's Gait,Duck Gait,Gait Disorder, Sensorimotor,Gait Dysfunction, Neurologic,Gait, Athetotic,Gait, Broadened,Gait, Drop Foot,Gait, Festinating,Gait, Frontal,Gait, Hemiplegic,Gait, Hysterical,Gait, Reeling,Gait, Rigid,Gait, Scissors,Gait, Shuffling,Gait, Spastic,Gait, Stumbling,Gait, Unsteady,Gait, Widebased,Locomotion Disorders, Neurologic,Marche a Petit Pas,Neurologic Ambulation Disorders,Neurologic Locomotion Disorders,Rapid Fatigue of Gait,Sensorimotor Gait Disorder,Ambulation Disorder, Neurologic,Athetotic Gait,Broadened Gait,Charcot Gaits,Charcots Gait,Drop Foot Gait,Festinating Gait,Foot Gait, Drop,Frontal Gait,Gait Disorder, Neurologic,Gait Disorders, Sensorimotor,Gait Dysfunctions, Neurologic,Gait, Charcot,Gait, Charcot's,Gait, Duck,Gaits, Charcot,Hemiplegic Gait,Hysterical Gait,Locomotion Disorder, Neurologic,Neurologic Ambulation Disorder,Neurologic Gait Disorder,Neurologic Gait Disorders,Neurologic Gait Dysfunction,Neurologic Gait Dysfunctions,Neurologic Locomotion Disorder,Reeling Gait,Rigid Gait,Scissors Gait,Sensorimotor Gait Disorders,Shuffling Gait,Shuffling Gaits,Spastic Gait,Stumbling Gait,Unsteady Gait,Widebased Gait

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