Abstract Details

Title A Simple Computerized Quantification of Gait Measures before and after CSF Removal in Evaluation of NPH

Topic Movement Disorders

Presentation(s) P07 - (-)

Poster/Presentation
Number 261

Objective

Background BACKGROUND: Gait impairments are often the most pronounced symptoms in NPH. Predicting those with suspected NPH who are most likely to improve with cerebrospinal fluid shunting remains a challenge. The most commonly used tool to select patients for shunt surgery is pre- and post-TT evaluation. The subjective nature of this evaluation may be an important reason for its low sensitivity in predicting success of shunt surgery.

Design/Methods DESIGN/METHODS: Eight patients with MRI and clinical features suspecting NPH were studied (mean age: 75.5 ± 4.6 years, range 70-84 years, 5 females). Sensors were placed on the patients' wrists, ankles, lumbar region, and sternum. Each sensor allowed 3-D acceleration and angular measurements as a function of time. During pre- and post-TT evaluation, patients performed 3 trials of Timed Up and Go test (TUG) that involved getting up from a chair, 25-foot walk, turn around, walk back to the chair, and sit down, during which patients movements were recorded and gait and turning indices were calculated. The pre-TT and post-TT trials were performed one week prior to TT and a few hours after TT procedure, respectively. The pre- and post- TT performances were compared using Wilcoxon signed rank test.

Results RESULTS: Of the various indices, cadence (4/8 subjects), double support duration (6/8), swing time (6/8), stance time (4/8), peak velocity during turning (6/8), and turn duration (6/8) improved following TT (p < 0.05).

Conclusions CONCLUSIONS: Quantitative gait evaluation may be a rapid, simple, and objective method of identifying patients who improve with TT that may improve identification of patients with definite response to TT. This may in turn lead to better selection of patients with suspected NPH for shunt surgery.

Authors/Disclosures
Narayanan Krishnamurthi PRESENTER	No disclosure on file
Terry D. Fife, MD, FAAN (Barrow Neurological Institute)	Dr. Fife has nothing to disclose.
Jiong Shi, MD, FAAN (Lou Ruvo Center for Brain Health- Cleveland Clinic Nevada)	Dr. Shi has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Roche.
Volker A. Knappertz, MD (Lacum Neurology)	Dr. Knappertz has received personal compensation for serving as an employee of Noema Pharmaceuticals . Dr. Knappertz has received personal compensation in the range of $50,000-$99,999 for serving as an officer or member of the Board of Directors for Sutura Pharmaceutical . Dr. Knappertz has received intellectual property interests from a discovery or technology relating to health care.

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