Associations among falls, gait variability, and balance function in idiopathic normal pressure hydrocephalus

•iNPH-associated gait and balance disturbances can increase the risk of falling.•The factors influencing falls in patients with iNPH remain unclear.•Advanced age and gait-balance instability increased the risk of falling.•Our findings may help identify patients who are at high risk of falling.•This...

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Veröffentlicht in:Clinical neurology and neurosurgery 2019-08, Vol.183, p.105385-105385, Article 105385
Hauptverfasser: Nikaido, Yasutaka, Urakami, Hideyuki, Akisue, Toshihiro, Okada, Yohei, Katsuta, Naoya, Kawami, Yuki, Ikeji, Takuya, Kuroda, Kenji, Hinoshita, Tetsuya, Ohno, Hiroshi, Kajimoto, Yoshinaga, Saura, Ryuichi
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container_title Clinical neurology and neurosurgery
container_volume 183
creator Nikaido, Yasutaka
Urakami, Hideyuki
Akisue, Toshihiro
Okada, Yohei
Katsuta, Naoya
Kawami, Yuki
Ikeji, Takuya
Kuroda, Kenji
Hinoshita, Tetsuya
Ohno, Hiroshi
Kajimoto, Yoshinaga
Saura, Ryuichi
description •iNPH-associated gait and balance disturbances can increase the risk of falling.•The factors influencing falls in patients with iNPH remain unclear.•Advanced age and gait-balance instability increased the risk of falling.•Our findings may help identify patients who are at high risk of falling.•This will allow the implementation of suitable prevention strategies. The factors influencing falls in idiopathic normal pressure hydrocephalus (iNPH) remain unclear, although iNPH-associated gait and balance disturbances can lead to an increased risk of falls. This study aimed to investigate the associations among fall status, gait variability, balance function in iNPH, and to identify fall-related factors in iNPH. Sixty-three patients with iNPH with a positive cerebrospinal fluid tap test result according to the iNPH diagnosis criteria participated in this prospective cross-sectional study. Patients were assessed using the 10-meter walk test (10MWT), the Functional Gait Assessment (FGA), the Berg Balance Scale (BBS), and the isometric quadriceps strength (QS). We also investigated each patient’s history of falls in the past 6 months. Gait variability was measured using a triaxial accelerometer attached to the patient’s torso at the L3 vertebra level during the 10MWT. Fall status correlated significantly with gait variability (measured as the coefficient of variation; CV) in step time and movement trajectory amplitude (i.e., center of mass movement) in the medial/lateral (ML) and vertical (VT) directions, with balance function as assessed by FGA and BBS scores. In contrast, QS was not correlated with fall status. The independent variables associated with the risk of falling were step time CV, FGA score, and age. The factors associated with the risk of falling in iNPH were aging and gait-balance instability, particularly temporal gait variability and dynamic balance dysfunction. Our results may enable physicians to identify the patients with iNPH who are at risk of falling and implement suitable prevention strategies.
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The factors influencing falls in idiopathic normal pressure hydrocephalus (iNPH) remain unclear, although iNPH-associated gait and balance disturbances can lead to an increased risk of falls. This study aimed to investigate the associations among fall status, gait variability, balance function in iNPH, and to identify fall-related factors in iNPH. Sixty-three patients with iNPH with a positive cerebrospinal fluid tap test result according to the iNPH diagnosis criteria participated in this prospective cross-sectional study. Patients were assessed using the 10-meter walk test (10MWT), the Functional Gait Assessment (FGA), the Berg Balance Scale (BBS), and the isometric quadriceps strength (QS). We also investigated each patient’s history of falls in the past 6 months. Gait variability was measured using a triaxial accelerometer attached to the patient’s torso at the L3 vertebra level during the 10MWT. Fall status correlated significantly with gait variability (measured as the coefficient of variation; CV) in step time and movement trajectory amplitude (i.e., center of mass movement) in the medial/lateral (ML) and vertical (VT) directions, with balance function as assessed by FGA and BBS scores. In contrast, QS was not correlated with fall status. The independent variables associated with the risk of falling were step time CV, FGA score, and age. The factors associated with the risk of falling in iNPH were aging and gait-balance instability, particularly temporal gait variability and dynamic balance dysfunction. 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The factors influencing falls in idiopathic normal pressure hydrocephalus (iNPH) remain unclear, although iNPH-associated gait and balance disturbances can lead to an increased risk of falls. This study aimed to investigate the associations among fall status, gait variability, balance function in iNPH, and to identify fall-related factors in iNPH. Sixty-three patients with iNPH with a positive cerebrospinal fluid tap test result according to the iNPH diagnosis criteria participated in this prospective cross-sectional study. Patients were assessed using the 10-meter walk test (10MWT), the Functional Gait Assessment (FGA), the Berg Balance Scale (BBS), and the isometric quadriceps strength (QS). We also investigated each patient’s history of falls in the past 6 months. Gait variability was measured using a triaxial accelerometer attached to the patient’s torso at the L3 vertebra level during the 10MWT. Fall status correlated significantly with gait variability (measured as the coefficient of variation; CV) in step time and movement trajectory amplitude (i.e., center of mass movement) in the medial/lateral (ML) and vertical (VT) directions, with balance function as assessed by FGA and BBS scores. In contrast, QS was not correlated with fall status. The independent variables associated with the risk of falling were step time CV, FGA score, and age. The factors associated with the risk of falling in iNPH were aging and gait-balance instability, particularly temporal gait variability and dynamic balance dysfunction. 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The factors influencing falls in idiopathic normal pressure hydrocephalus (iNPH) remain unclear, although iNPH-associated gait and balance disturbances can lead to an increased risk of falls. This study aimed to investigate the associations among fall status, gait variability, balance function in iNPH, and to identify fall-related factors in iNPH. Sixty-three patients with iNPH with a positive cerebrospinal fluid tap test result according to the iNPH diagnosis criteria participated in this prospective cross-sectional study. Patients were assessed using the 10-meter walk test (10MWT), the Functional Gait Assessment (FGA), the Berg Balance Scale (BBS), and the isometric quadriceps strength (QS). We also investigated each patient’s history of falls in the past 6 months. Gait variability was measured using a triaxial accelerometer attached to the patient’s torso at the L3 vertebra level during the 10MWT. Fall status correlated significantly with gait variability (measured as the coefficient of variation; CV) in step time and movement trajectory amplitude (i.e., center of mass movement) in the medial/lateral (ML) and vertical (VT) directions, with balance function as assessed by FGA and BBS scores. In contrast, QS was not correlated with fall status. The independent variables associated with the risk of falling were step time CV, FGA score, and age. The factors associated with the risk of falling in iNPH were aging and gait-balance instability, particularly temporal gait variability and dynamic balance dysfunction. Our results may enable physicians to identify the patients with iNPH who are at risk of falling and implement suitable prevention strategies.</abstract><cop>Netherlands</cop><pub>Elsevier B.V</pub><pmid>31207457</pmid><doi>10.1016/j.clineuro.2019.105385</doi><tpages>1</tpages><orcidid>https://orcid.org/0000-0002-5250-9023</orcidid></addata></record>
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subjects Accelerometers
Age
Aging
Balance
Balance disturbance
Balance function
Cerebrospinal fluid
Coefficient of variation
Cognitive ability
Dynamic stability
Fall risk
Falls
Gait
Gait disturbance
Gait variability
Hydrocephalus
Idiopathic normal pressure hydrocephalus
Independent variables
Isometric
Medical personnel
Neurology
Posture
Pressure
Quadriceps muscle
Risk assessment
Spine
Standard deviation
Torso
Urinary incontinence
Variability
Velocity
Vertebrae
title Associations among falls, gait variability, and balance function in idiopathic normal pressure hydrocephalus
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