Postural function in idiopathic normal pressure hydrocephalus before and after shunt surgery: A controlled study using computerized dynamic posturography (EquiTest)

• Introduction: Postural dysfunction is one of the major features of idiopathic normal pressure hydrocephalus (iNPH). With computerized dynamic posturography (CDP) balance can be assessed objectively. The primary aim of this study was to describe the postural function- in iNPH patients pre- and postoperatively in comparison with healthy individuals (HI) using CDP. Subjects and methods: Thirty-five patients (16 M, 19 F) with a mean age of 73 (range 49-81) with iNPH, and sixteen HI (7 M, 9 F) aged 73 (62-89) were included. iNPH patients were operated on with a ventriculoperitoneal shunt. Patients and HI were tested regarding motor function, balance and cognition. COP, EquiTest (NeuroCom International, Clackamas, OR), was performed before and three months after shunt surgery and twice in HI, with a three-month interval. Results: Pre-operatively, the 35 patients had poorer balance measured with the Sensory Organizing Test (SOT) score in every condition (p = 0.01 in SOT 1 and p <0.001 in SOT 2-6) compared to the HI. The greatest difference was in test conditions measuring mainly vestibular function, where loss of balance (LOB) was frequent. Twenty patients were evaluated three months after shunt surgery and 18/20 (90%) of them were considered shunt responders, with a mean improvement of motor score of 26% (range 5-67%). There was an improvement post-operatively in the weighted composite SOT score (p <0.05) but no significant change in any of the SOT conditions. LOB was not significantly reduced in any of the test conditions. Conclusion: CDP showed that the patients had a poorer balance than the HI. The greatest difference was in SOT 5-6, indicating that the postural disturbance is of primarily central vestibular origin. There was a slight improvement of balance post-operatively.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine (hsv//eng)

Nyckelord

Idiopathic normal pressbre hydrocephalus

Postural function

Computerized dynamic posturography

SENSORY ORGANIZATION

BALANCE ASSESSMENT

ELDERLY PATIENTS

GAIT

DISORDERS

RISK

DISTURBANCE

PREVALENCE

DEFICITS

DISEASE

Idiopathic normal pressbre hydrocephalus

MEDICINE

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