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Interventional study demonstrates dual-task gait improvements after CSF tapping in suspected normal pressure hydrocephalus, indicating greater diagnostic sensitivity than standard single-task tests.
BACKGROUND: Gait disorders in patients with idiopathic normal pressure hydrocephalus (iNPH) share similar characteristics found in pathologies presenting with higher-level gait disorders that have been specifically associated with gait changes during walking while simultaneously performing an attention-demanding task (i.e. dual tasking). The current study assessed the effect of cerebrospinal fluid (CSF) tapping on quantitative gait modification during single and dual tasking in patients with a suspicion of iNPH. METHODS: Of 53 patients suspected of iNPH, 18 have been included in this study. Gait analysis during single- and dual-task condition (walking and backward counting) before and after tapping of 40 ml CSF has been performed. RESULTS: Gait speed (P < 0.01) and stride length (P < 0.05) were significantly improved during dual-task conditions after CSF tapping compared to the gait performance before spinal tapping, without such improvement for gait parameters during single-tasking. CONCLUSION: Dual-tasking condition better reveals gait improvement after CSF tapping than single-tasking in patients suspected of iNPH.
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Armand et al. (2010) studied this question.
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