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https://hdl.handle.net/1822/90206
Título: | Quantitative gait analysis value as a predictor of shunt surgery effectiveness in normal pressure hydrocephalus: A technical note |
Autor(es): | Gago, Miguel F. Ferreira, Flora Bicho, Estela |
Palavras-chave: | Normal pressure hydrocephalus Gait analysis Shunt surgery CSF tap test |
Data: | 4-Ago-2022 |
Editora: | Elsevier 1 |
Revista: | Clinical Neurology and Neurosurgery |
Citação: | Gago, M. F., Ferreira, F., & Bicho, E. (2022, October). Quantitative gait analysis value as a predictor of shunt surgery effectiveness in normal pressure hydrocephalus: A technical note. Clinical Neurology and Neurosurgery. Elsevier BV. http://doi.org/10.1016/j.clineuro.2022.107405 |
Resumo(s): | Introduction: Shunt surgery (SS) remains the most effective treatment for idiopathic Normal pressure hydro-cephalus (iNPH), but the selection of the patients with the greatest potential benefit remains elusive.Objective: Identify gait features predictive of best response to SS in iNPH.Methods: Eight patients with iNPH were assessed at baseline, after Cerebrospinal fluid tap-test (CSF-TT) and SS, with clinical scales (Clinical/Patient Global Clinical Impression, EuroQol-5D, Clinical Dementia Rating Scale (CDR), MoCA test, Hoehn-Yahr Scale) and gait analysis with inertial sensors.Results: The 8 included iNPH patients had a mean age of 73 years(59-81), moderate cognitive (CDR-1.5 (0.5-2); MoCA-9.5 (3-21)) and motor impairment (Hoehn-Yahr-2.75(2-3)). After SS, patients had a significant improvement in cognition (MoCA, p = 0.001) and quality of life. At baseline, patients with lower improvement (no change/ minimally improved) (n = 2), in comparison to patient with higher improvement (much/very much improved) (n = 6), already had higher cognitive impairment (MoCa-3(3-3) vs. 11(7-21)). Patients with lower improvement had a lower % of change in gait performance at LP (mean 10.2 %) and were absent of additional benefit after SS(mean-0.8 %). In contrast, gait performance in patients with higher improvement consistently got better from baseline to LP (mean 23.1 %) and from baseline to SS (mean 82.9 %). A significant negative correlation was observed between CDR score and several gait variables: speed (rpb=-0.92,p = 0.009); stride length (rpb=-0.92,p = 0.009); lift-off angle (rpb=-0.96,p = 0.003); and maximum heel (rpb=-0.81,p = 0.049).Conclusion: The magnitude of gait improvement after CSF-TT, quantified by gait analysis, can be used as an integral variable in the multimodal clinical approach to the prediction of improvement after SS. |
Tipo: | Artigo |
URI: | https://hdl.handle.net/1822/90206 |
DOI: | 10.1016/j.clineuro.2022.107405 |
ISSN: | 0303-8467 |
Versão da editora: | https://www.sciencedirect.com/science/article/pii/S0303846722002864 |
Arbitragem científica: | yes |
Acesso: | Acesso restrito UMinho |
Aparece nas coleções: | CAlg - Artigos em revistas internacionais / Papers in international journals |
Ficheiros deste registo:
Ficheiro | Descrição | Tamanho | Formato | |
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Paper_Quantitative_Gait_Analysis_Flora_Miguel_Estela1-s2.0-S0303846722002864-main.pdf Acesso restrito! | 789,12 kB | Adobe PDF | Ver/Abrir |