Gait analysis in idiopathic normal pressure hydrocephalus -: which parameters respond to the CSF tap test?

被引:138
作者
Stolze, H
Kuhtz-Buschbeck, JP
Drücke, H
Jöhnk, K
Diercks, C
Palmié, S
Mehdorn, HM
Illert, M
Deuschl, G
机构
[1] Univ Kiel, Dept Neurol, D-24105 Kiel, Germany
[2] Dept Physiol, D-24098 Kiel, Germany
[3] Dept Radiol, D-24105 Kiel, Germany
[4] Dept Neurosurg, D-24106 Kiel, Germany
关键词
normal pressure hydrocephalus; CSF tap test; gait analysis;
D O I
10.1016/S1388-2457(00)00362-X
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Objectives: Normal pressure hydrocephalus (NPH) is an often underestimated cause of hypokinetic gait disorders in the elderly. Diagnosing NPH is a complex problem, since many symptoms overlap with other neurological diseases. The purpose of the present study was to characterize the gait pattern in NPH quantitatively. Additionally, we analyzed the improvement of gait parameters following tapping of cerebrospinal fluid (CSF). Methods: Gait analysis was performed in 10 patients and 12 age-matched healthy controls during overground and treadmill locomotion. Results: Compared to healthy controls, patients with NPH walked significantly slower, with shorter and more variable strides and a somewhat lower cadence. The feet were not lifted to a normal height and the dorsal extension of the forefoot prior to heel-strike was insufficient. Balance-related gait parameters such as step width and the foot rotation angles were significantly increased in NPH, while their variability was lower. Only some gait parameters improved after tapping 30 mi CSF. Gait velocity increased by about 23% due to an increased stride length, while the cadence remained unchanged. Balance-related gait parameters and the foot-to-floor clearance during swing were not affected by the treatment. Conclusions: In conclusion, we found a triad of decreased stride length, decreased foot-to-floor clearance and a broad-based gait to be the typical features of the gait abnormality in NPH. Only the stride length improved following a diagnostic spinal tap. These results may help to more reliably diagnose the condition of NPH in a routine clinical setting. (C) 2000 Elsevier Science Ireland Ltd. All rights reserved.
引用
收藏
页码:1678 / 1686
页数:9
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