The Effects of Ventriculoperitoneal Shunt on Gait Performance

Overview

Journal J Med Life

Specialty General Medicine

Date 2019 Sep 5

PMID 31481979

Citations 3

Authors

Dumitru Baltateanu

Ileana Ciobanu

Mihai Berteanu

Affiliations

Soon will be listed here.

Abstract

Most studies on patients with normal pressure hydrocephalus (NPH) regard pre-post Tap test and long-term follow-up after shunt surgery. Quantitative and qualitative assessment tools specific to rehabilitation medicine can provide an objective measurement of the benefit of the neurosurgical intervention at 1-month follow-up. The aim of this retrospective study was to assess the early benefit of the ventriculoperitoneal shunt with low or medium pressure valve on the gait capacity of persons with NPH, one month after surgery. This is a retrospective study reviewing 19 inpatients with NPH who underwent neurosurgery for ventriculoperitoneal shunt with low or medium pressure valve, one month after a positive result on a tap test, in a 5-year period. The assessments regarding the gait abilities were performed 24 hours before the surgical intervention and one month after surgery. Assessment tools used were: the 3 meters Timed Up and Go Test (TUG), the 10 Meters Walking Test (10MWT) and the Berg Balance Scale. A positive response to the tap test predicted improvements of gait and balance in patients with NPH after shunt surgery. Best results in regards to gait and balance are achieved when early diagnosis and intervention are performed. Complex comorbidities generate and enhance significant and persistent gait impairment.

Citing Articles

Gait characteristics in idiopathic normal pressure hydrocephalus: a review on the effects of CSF tap test and shunt surgery.

Hereitova I, Griffa A, Allali G, Dornak T Eur J Med Res. 2024; 29(1):633.

PMID: 39734225 PMC: 11684308. DOI: 10.1186/s40001-024-02162-2.

Cerebrospinal fluid production rate in various pathological conditions: a preliminary study.

Tariq K, Toma A, Khawari S, Amarouche M, Elborady M, Thorne L Acta Neurochir (Wien). 2023; 165(8):2309-2319.

PMID: 37354286 PMC: 10409822. DOI: 10.1007/s00701-023-05650-2.

Gait, falls, cognitive function, and health-related quality of life after shunt-treated idiopathic normal pressure hydrocephalus-a single-center study.

Hallqvist C, Gronstedt H, Arvidsson L Acta Neurochir (Wien). 2022; 164(9):2367-2373.

PMID: 35831723 PMC: 9427897. DOI: 10.1007/s00701-022-05309-4.

References

Shumway-Cook A, Brauer S, Woollacott M . Predicting the probability for falls in community-dwelling older adults using the Timed Up & Go Test. Phys Ther. 2000; 80(9):896-903. View

Berg K, Williams J, Maki B . Measuring balance in the elderly: validation of an instrument. Can J Public Health. 1992; 83 Suppl 2:S7-11. View

Krauss J, Halve B . Normal pressure hydrocephalus: survey on contemporary diagnostic algorithms and therapeutic decision-making in clinical practice. Acta Neurochir (Wien). 2004; 146(4):379-88. DOI: 10.1007/s00701-004-0234-3. View

Perera S, Mody S, Woodman R, Studenski S . Meaningful change and responsiveness in common physical performance measures in older adults. J Am Geriatr Soc. 2006; 54(5):743-9. DOI: 10.1111/j.1532-5415.2006.00701.x. View

Vanneste J, Augustijn P, Dirven C, Tan W, Goedhart Z . Shunting normal-pressure hydrocephalus: do the benefits outweigh the risks? A multicenter study and literature review. Neurology. 1992; 42(1):54-9. DOI: 10.1212/wnl.42.1.54. View

Ravdin L, Katzen H, Jackson A, Tsakanikas D, Assuras S, Relkin N . Features of gait most responsive to tap test in normal pressure hydrocephalus. Clin Neurol Neurosurg. 2008; 110(5):455-61. PMC: 2690636. DOI: 10.1016/j.clineuro.2008.02.003. View

Huang S, Hsieh C, Wu R, Tai C, Lin C, Lu W . Minimal detectable change of the timed "up & go" test and the dynamic gait index in people with Parkinson disease. Phys Ther. 2010; 91(1):114-21. DOI: 10.2522/ptj.20090126. View

Ishii M, Kawamata T, Akiguchi I, Yagi H, Watanabe Y, Watanabe T . Parkinsonian Symptomatology May Correlate with CT Findings before and after Shunting in Idiopathic Normal Pressure Hydrocephalus. Parkinsons Dis. 2010; 2010. PMC: 2951141. DOI: 10.4061/2010/201089. View

Mori E, Ishikawa M, Kato T, Kazui H, Miyake H, Miyajima M . Guidelines for management of idiopathic normal pressure hydrocephalus: second edition. Neurol Med Chir (Tokyo). 2012; 52(11):775-809. DOI: 10.2176/nmc.52.775. View

10.

Barry E, Galvin R, Keogh C, Horgan F, Fahey T . Is the Timed Up and Go test a useful predictor of risk of falls in community dwelling older adults: a systematic review and meta-analysis. BMC Geriatr. 2014; 14:14. PMC: 3924230. DOI: 10.1186/1471-2318-14-14. View

11.

Lusardi M, Fritz S, Middleton A, Allison L, Wingood M, Phillips E . Determining Risk of Falls in Community Dwelling Older Adults: A Systematic Review and Meta-analysis Using Posttest Probability. J Geriatr Phys Ther. 2016; 40(1):1-36. PMC: 5158094. DOI: 10.1519/JPT.0000000000000099. View

12.

Ishikawa M, Yamada S, Yamamoto K . Early and delayed assessments of quantitative gait measures to improve the tap test as a predictor of shunt effectiveness in idiopathic normal pressure hydrocephalus. Fluids Barriers CNS. 2016; 13(1):20. PMC: 5120418. DOI: 10.1186/s12987-016-0044-z. View

13.

Israelsson H, Carlberg B, Wikkelso C, Laurell K, Kahlon B, Leijon G . Vascular risk factors in INPH: A prospective case-control study (the INPH-CRasH study). Neurology. 2017; 88(6):577-585. PMC: 5304464. DOI: 10.1212/WNL.0000000000003583. View

14.

Nassar B, Lippa C . Idiopathic Normal Pressure Hydrocephalus: A Review for General Practitioners. Gerontol Geriatr Med. 2017; 2:2333721416643702. PMC: 5119812. DOI: 10.1177/2333721416643702. View

15.

Mendes G, de Oliveira M, Pinto F . The Timed Up and Go Test as a Diagnostic Criterion in Normal Pressure Hydrocephalus. World Neurosurg. 2017; 105:456-461. DOI: 10.1016/j.wneu.2017.05.137. View

16.

Yamada S, Ishikawa M, Miyajima M, Nakajima M, Atsuchi M, Kimura T . Timed up and go test at tap test and shunt surgery in idiopathic normal pressure hydrocephalus. Neurol Clin Pract. 2017; 7(2):98-108. PMC: 5669413. DOI: 10.1212/CPJ.0000000000000334. View

17.

Pin S, Spini D . Impact of falling on social participation and social support trajectories in a middle-aged and elderly European sample. SSM Popul Health. 2018; 2:382-389. PMC: 5757958. DOI: 10.1016/j.ssmph.2016.05.004. View

18.

Gallagher R, Marquez J, Osmotherly P . Gait and Balance Measures Can Identify Change From a Cerebrospinal Fluid Tap Test in Idiopathic Normal Pressure Hydrocephalus. Arch Phys Med Rehabil. 2018; 99(11):2244-2250. DOI: 10.1016/j.apmr.2018.03.018. View

19.

de Souza R, da Rocha S, Tomazini Martins R, Kowacs P, Ramina R . Gait in normal pressure hydrocephalus: characteristics and effects of the CSF tap test. Arq Neuropsiquiatr. 2018; 76(5):324-331. DOI: 10.1590/0004-282X20180037. View

20.

Caronni A, Picardi M, Aristidou E, Antoniotti P, Pintavalle G, Redaelli V . How do patients improve their timed up and go test? Responsiveness to rehabilitation of the TUG test in elderly neurological patients. Gait Posture. 2019; 70:33-38. DOI: 10.1016/j.gaitpost.2019.02.010. View