Clinical improvements in temporospatial gait variables after a spinal tap test in individuals with idiopathic normal pressure hydrocephalus

Background: Idiopathic Normal Pressure Hydrocephalus (iNPH) is a neurological condition that often presents gait disturbance in the early stages of the disease and affects other motor activities. This study investigated changes in temporospatial gait variables after cerebrospinal fluid (CSF) removal using a tap test in individuals with idiopathic normal pressure hydrocephalus (iNPH), and explored if the tap test responders and non-responders could be clinically identified from temporospatial gait variables. Methods: Sixty-two individuals with iNPH were recruited from an outpatient clinic, eleven were excluded, leaving a total of 51 who were included in the analysis. Temporospatial gait variables at self-selected speed were recorded at pre- and 24-hour post-tap tests which were compared using Paired t-tests, Cohen’s d effect size, and percentage change. A previously defined minimal clinical important change (MCIC) for gait speed was used to determine the changes and to classify tap test responders and non-responders. A mixed model ANOVA was used to determine the within-group, between-group, and interaction effects. Results: Comparisons of the data between pre- and post-tap tests showed significant improvements with small to medium effect sizes for left step length, right step time, stride length and time, cadence, and gait speed. Gait speed showed the largest percentage change among temporospatial gait variables. Within-group and interaction effects were found in some variables but no between-group effect was found. Tap test responders showed significant improvements in right step length and time, stride length and time, cadence, and gait speed while non-responders did not. Conclusions: Some individuals with iNPH showed clinically important improvements in temporospatial gait variables after the tap test, particularly in step/stride length and time, cadence, who could be classified by gait speed. However, gait-related balance variables did not change. Therefore, additional treatments should focus on improving such variables

Effect of sound on standing postural stability in the elderly with and without knee osteoarthritis

The aim of the study was to investigate the influence of sound on standing postural control in the elderly with and without knee osteoarthritis (knee-OA). Methods: Twenty-six elderly with knee-OA and 26 elderly without knee-OA who matched the age and height participated in this study. The standing postural stability was assessed by the 3D motion analysis system. Four testing conditions of the combination of sound (no sound and white noise sound) and surface (firm and soft surfaces) were tested three times with eyes closed for 30 sec. Postural stability variables included the standard deviation and velocity of the centre of pressure, the total body centre of mass, and centre of the head along the antero-posterior (AP) and medio-lateral (ML) directions. Results: Statistical significant reductions of all variables along ML direction were found in the elderly without a knee-OA in the presence of sound during standing on a firm surface. No significant effect of sound was found in the elderly with the knee-OA during standing on a firm surface. In the standing on a soft surface, both groups demonstrated no significant effect of sound on all postural stability variables. Conclusions: Application of sound improved the standing postural stability in the frontal plane for the elderly without knee-OA. However, the effect of sound was limited in standing on a soft surface for both elderly with and without knee-OA