Dynamic Balance Measurements Can Differentiate Patients Who Fall From Patients Who Do Not Fall in Patients With Idiopathic Normal Pressure Hydrocephalus

Perceived and actual changes in gait balance after CSF shunting in idiopathic normal pressure hydrocephalus

“…13,15 This cutoff value for each variable was calculated using Youden's index methods (maximum [sensitivity +specificity -1]). 6,28 To confirm the influence of the degree of gait-balance disturbance, we conducted a subgroup analysis of patients with TUG times <15 s (TUG <15 s group) 6 and those with TUG times ≥15 s (TUG ≥15 s group), including both the actual value change and the MCIDs following CSF shunt surgery. We defined statistical significance as p < 0.05.…”

“…The TUG test is commonly used for the assessment of functional mobility in gait and balance 21 in various neurologic disorders, including iNPH. 6,17,29,30 Similarly, MCIDs using the GRC scale of gait and balance measures is well adapted to determine the effectiveness of interventions for neurologic disorders. 13,15,31,32 In the present study, the actual TUG value change in the TUG ≥15 s group was found to be greater than the TUG MCIDs, whereas the actual TUG changes in the TUG <15 s group were found to be less than the TUG MCIDs.…”

“…20 If the patient was at risk of falling, the assessor followed the patient a half-step behind to prevent a fall without interfering with the patients' normal walking pace. 6,17,21 The patients performed two normal-paced TUG trials, and the meantime of the two trials was used for analysis. 6,17,21 The FGA, 22 which comprises 10 items, can be used to assess dynamic balance function, including postural control during gait for patients with neurological disorders, including vestibular disorders and iNPH.…”

“…6,17,21 The patients performed two normal-paced TUG trials, and the meantime of the two trials was used for analysis. 6,17,21 The FGA, 22 which comprises 10 items, can be used to assess dynamic balance function, including postural control during gait for patients with neurological disorders, including vestibular disorders and iNPH. 22 The 10 items of the FGA are 22 Each item is scored on a 4-level ordinal scale (0-3 points) with a total score of 30 points.…”

“…[2][3][4][5] In addition, a previous study has reported that even in the mild stage of iNPH, that is, mild gait disturbance characterized by a timed Up and Go (TUG) test time of less than 15 s, the fall rate is as high as 60%. 6 Regarding the fall risk assessment for iNPH, including mild cases, a previous study has shown that a dynamic balance assessment including vestibular function assessment, such as the Functional Gait Assessment (FGA), is more suitable than other assessments, such as the 10-meter walk test, TUG test, static balance test, or lower limb muscle strength for differentiating iNPH patients at high risk of falls from those with low risk of falls. 6 These findings have provided an important perspective for clinicians in terms of early diagnosis and treatment of iNPH.…”