Physical exercise and goal attainment after shunt surgery in idiopathic normal pressure hydrocephalus: a randomised clinical trial

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Rydja, JohannaLinköpings universitet,Institutionen för biomedicinska och kliniska vetenskaper,Medicinska fakulteten,Region Östergötland, Rörelse och Hälsa (author)

Physical exercise and goal attainment after shunt surgery in idiopathic normal pressure hydrocephalus: a randomised clinical trial

Article/chapterEnglish2021

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2021-11-22
Springer Science and Business Media LLC,2021
electronicrdacarrier

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LIBRIS-ID:oai:gup.ub.gu.se/310404
https://gup.ub.gu.se/publication/310404URI
https://doi.org/10.1186/s12987-021-00287-8DOI
https://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-181679URI

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Language:English

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SwePubSwePub

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Subject category:ref swepub-contenttype
Subject category:art swepub-publicationtype

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Funding Agencies|Linkoping University; Region Ostergotland; Rune and Ulla Amlov foundation; Edit Jacobson foundation; foundation Hjalmar Svenssons forskningsfond; Swedish government [ALFGBG 720121]; Swedish County Councils, the ALF-agreement [ALFGBG 720121]
Background: Rehabilitation in iNPH is suggested to be an important factor to improve patients'functions but there are lack of clinical trials evaluating the effect of rehabilitation interventions after shunt surgery in iNPH. The objective of this study was to evaluate the effect of a physical exercise programme and goal attainment for patients with idiopathic normal pressure hydrocephalus (iNPH) after surgery compared to a control group. Methods: This was a dual centre randomised controlled trial with assessor blinding, intention-to-treat (ITT) and per protocol (PP) analysis. Individuals diagnosed with iNPH scheduled to undergo shunt surgery at the Linkoping University Hospital in Linkoping and Sahlgrenska University Hospital in Gothenburg, Sweden were consecutively eligible for inclusion. Inclusion was conducted between January 2016 and June 2018. The patients were randomised 1:1 using sequentially numbered sealed envelopes to receive either written exercise information (control group) or written information and an additional supervised high-intensity, functional exercise programme (HIFE) executed twice weekly over 12 weeks (exercise group). Preoperatively, the patients set individual goals. The primary outcome was change from baseline in the total iNPH scale score at the post-intervention follow-up. Secondary outcomes were goal attainment, and change in the separate scores of gait, balance, neuropsychology and continence and in the total score after 6 months. Results: In total, 127 participants were randomised to the exercise group (n = 62) and to the control group (n=65). In the ITT population (exercise group, n =50; control group, n=59), there were no between-group differences in the primary outcome, but the attrition rate in the exercise group was high. The exercise group improved more than the control group in the balance domain scores after 6 months. Post-intervention, the PP exercise population achieved their set goals to a greater extent than the controls. Conclusions: An additional effect of the 12-week HIFE-programme on the overall improvement according to the iNPH-scale after shunt surgery in iNPH was not shown. This could be due to high attrition rate. However, the longterm effect on balance and higher goal achievement indicate beneficial influences of supervised physical exercise.

Subject headings and genre

MEDICIN OCH HÄLSOVETENSKAP Medicinska och farmaceutiska grundvetenskaper Neurovetenskaper hsv//swe
MEDICAL AND HEALTH SCIENCES Basic Medicine Neurosciences hsv//eng
MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Psykiatri hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Psychiatry hsv//eng
Idiopathic normal pressure hydrocephalus
Neurosurgical procedures
Rehabilitation
Exercise
older-people
program
motor
multicenter
management
dementia
Neurosciences & Neurology
Idiopathic normal pressure hydrocephalus; Neurosurgical procedures; Rehabilitation; Exercise

Added entries (persons, corporate bodies, meetings, titles ...)

Kollén, LenaGothenburg University,Göteborgs universitet,Institutionen för neurovetenskap och fysiologi,Institute of Neuroscience and Physiology,Univ Gothenburg, Sweden(Swepub:gu)xkolle (author)
Hellström, PerGothenburg University,Göteborgs universitet,Institutionen för neurovetenskap och fysiologi,Institute of Neuroscience and Physiology,Univ Gothenburg, Sweden(Swepub:gu)xheper (author)
Owen, KatarinaLinköpings universitet,Institutionen för hälsa, medicin och vård,Medicinska fakulteten,Region Östergötland, Rörelse och Hälsa(Swepub:liu)n/a (author)
Lundgren Nilsson, Åsa,1965Gothenburg University,Göteborgs universitet,Institutionen för neurovetenskap och fysiologi,Institute of Neuroscience and Physiology,Univ Gothenburg, Sweden(Swepub:gu)xlusaf (author)
Wikkelsö, Carsten,1947Gothenburg University,Göteborgs universitet,Institutionen för neurovetenskap och fysiologi,Institute of Neuroscience and Physiology,Univ Gothenburg, Sweden(Swepub:gu)xwikca (author)
Tullberg, Mats,1965Gothenburg University,Göteborgs universitet,Institutionen för neurovetenskap och fysiologi,Institutionen för neurovetenskap och fysiologi, sektionen för klinisk neurovetenskap,Institute of Neuroscience and Physiology,Institute of Neuroscience and Physiology, Department of Clinical Neuroscience,Univ Gothenburg, Sweden(Swepub:gu)xtumat (author)
Lundin, FredrikLinköpings universitet,Avdelningen för neurobiologi,Medicinska fakulteten,Region Östergötland, Neurologiska kliniken i Linköping(Swepub:liu)lunlu59 (author)
Linköpings universitetInstitutionen för biomedicinska och kliniska vetenskaper (creator_code:org_t)

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