Abstract
Objectives
To identify in patients with idiopathic normal pressure hydrocephalus (iNPH) undergoing
a cerebrospinal fluid (CSF) tap test (TT) for consideration of a ventricular peritoneal
(VP) shunt: (1) gait and balance measures, which identify symptom change; (2) differences
present between pre– and post–CSF TT scores between patients classified as responders
and nonresponder; (3) ability of patients with iNPH to accurately quantify change
in their gait and balance symptoms from a CSF TT.
Design
Prospective observational study. Post–CSF TT assessment was completed 2-4 hours post.
Setting
Tertiary referral neurological and neurosurgical hospital.
Participants
Patients (N=74) with iNPH receiving a 30 mL CSF TT for consideration of a VP shunt.
Interventions
Patients underwent a battery of gait and balance measures pre– and post–CSF TT and
indicated their perceived change on a global rating of change (GRC). Patients deemed
to improve and offered VP shunt insertion by a neurologist or neurosurgeon were labeled
responders.
Main Outcome Measures
Performance oriented mobility assessment (Tinetti), Berg Balance Scale (BBS), timed
Up and Go (TUG), 10-meter walk test (10MWT), GRC.
Results
Forty patients were classified responders, 34 nonresponders. Significant differences
were identified for responders: Tinetti (3.88 points), TUG (3.98 seconds), 10MWT (0.08
m/sec), and BBS (5.29 points). Significant differences were found for nonresponders
for the Tinetti (0.91 points) and BBS (2.06 points). Change scores for responders
and nonresponders were significantly different for all tests between responders and
nonresponders. GRC scores for gait (+2 for responders, 0 for nonresponders) and balance
(+2.5 for responders, 0 for nonresponders) were both significantly different.
Conclusions
The Tinetti, BBS, and TUG can identify change in patients undergoing a CSF TT for
iNPH. Patients appear to be able to accurately identify if change has occurred.
Keywords
List of abbreviations:
10MWT (10-meter walk test), BBS (Berg Balance Scale), CSF (cerebrospinal fluid), ELD (external lumbar drainage), GRC (global rating of change), iNPH (idiopathic normal pressure hydrocephalus), MDC (minimal detectable change), TUG (timed Up and Go), TT (tap test), VP (ventricular peritoneal)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: April 24, 2018
Footnotes
Supported by the University of Newcastle and Hunter New England Local Health District.
Identification
Copyright
© 2018 by the American Congress of Rehabilitation Medicine
