Article

OBJECTIVE: To present an objective method to evaluate gait improvements after a
tap test in idiopathic normal pressure hydrocephalus (INPH). DESIGN:
Retrospective analysis of gait data. SETTING: Public tertiary care center, day
hospital. The gait analysis was performed before and 2 to 4 hours after the tap
test. PARTICIPANTS: Participants included patients with INPH (n=60) and age- and
sex-matched controls (n=50; used to obtain reference intervals). From an initial
referred sample of 79 patients (N=79), we excluded those unable to walk without
walking aids (n=9) and those with incomplete (pre-/posttap test) gait data
(n=10). Thirteen out of 60 patients were shunted and then reappraised after 6
months. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Mahalanobis
distance from controls, before and after the tap test. Eleven gait parameters
were combined in a single quantitative score. Walking velocity was also evaluated
because it is frequently used in tap test assessment.
RESULTS: Patients were
classified into 2 groups: tap test responders (n=22, 9 of them were shunted) and
not suitable for shunt (n=38, 4 of them were shunted). In the tap test responders
group, 9 out of 9 patients improved after shunt. In the not suitable for shunt
group, 3 out of 4 patients did not improve. Gait velocity increased after the tap
test in 53% of responders and in 37% of patients not suitable for shunt.
CONCLUSIONS: The new method is applicable to clinical practice and allows for
selecting tap test responders in an objective way, quantifying the improvements.
Our results suggest that gait velocity alone is not sufficient to reliably assess
tap test effects.
CI - Copyright (c) 2015 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS