The analysis of gait disorders in patients with idiopathic normal pressure hydrocephalus / 中华老年医学杂志

ABSTRACT

Objective:To investigate the features of gait disorders in patients with idiopathic normal pressure hydrocephalus(iNPH).Methods:Clinical data of 42 patients diagnosed with iNPH admitted to the neurological department of Aviation General Hospital from March 2017 to July 2020 were consecutively collected.The features of gait disturbance and activity of daily living were retrospectively studied.Results:Of the 42 patients, 29 cases(69%)were males, aged(73.0±8.3)years, and 13 cases were females, aged(73.0±8.3)years old.The mean course of disease was(3.5±3.0)years.There were 90.5% of patients(38/42)complained of gait disorders, and 61.9%(26/42)had fall histories.All patients had gait abnormalities.The time for 3m-Timed Up and Go(TUG)test were(27.8±17.0)seconds, and the proportion of patients with the time for 3m-TUG less than 10 seconds, 10~20 seconds and more than 20 seconds were 5.9%(2/34), 35.3%(12/34)and 58.8%(20/34), respectively.In the 10-meter walking test, 8 patients needed assistance.Of the 34 patients who could walk independently, 94.1%(32/34)had tandem walking disturbed and tendency toward falling, 76.5%(26/34)had turning disturbed, 44.1%(15/34)had wide based stride and small steps, 29.4%(10/34)had trunk balance disturbed, 23.5%(8/34)had reduced foot-floor clearance, and 8.8%(3/34)had start hesitation, 97.6%(41/42)had abnormal step counting and 90.5%(38/42)had abnormal time evaluation.The proportion of patients with activity of daily living(Barthel Index)scores of(mild dependence), moderate dependence and severe dependence were 71.4%(30/42), 28.6%(12/42)and 0%(0/42). Of the 30 patients with mild dependence, 56.7%(17/30)had fall histories.Conclusions:In our study, all patients have gait dysfunction, which causes some impact on activity of daily living and a higher risk of falls.Gait slowness, tandem walking disturbed, turning disturbed, tendency toward falling, wide based stride and small steps are the most involved gait characteristics.Early assessment of gait disorders is of great significance in early diagnosis and the prevention of falls and living ability decline.