Relationship between gait parameters and MR imaging in idiopathic normal pressure hydrocephalus patients after shunt surgery
Relationship between gait parameters and MR imaging in idiopathic normal pressure hydrocephalus patients after shunt surgery
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DOI：
10.1016/j.gaitpost.2018.01.008
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发表时间：
2018-03-01
期刊：
影响因子：
2.4
通讯作者：
Matsumine, Akihiko
中科院分区：
文献类型：
--
作者：
Kitade, Ippei;Kitai, Ryuhei;Matsumine, Akihiko
背景资料：之前的一些研究报告了特发性正常压力脑积水（iNPH）患者在分流手术后与分流手术前相比步态运动的变化;然而，尚未对步态进行详细的定量研究，包括动力学和运动学参数。此外，步态参数和磁共振（MR）imaging.Research question之间的关系尚未得到证实：我们调查了步态运动与iNPH患者，并评估之间的关系动力学步态参数和MR imaging before and after shunt surgery.Methods：受试者是12例iNPH患者谁可以走10米没有aids。使用三维运动分析系统获得手术前后的时空、动力学和运动学参数。每个步态参数和MR imaging之间的关系进行了assessed.Results：分流后的步行速度和步长增加与分流前的值。分流后评价显示步态周期中矢状面中髋关节、膝关节和踝关节的活动范围增加。分流术后，站立期髋关节的峰值屈曲力矩更大。Evans指数改善率与步行速度改善率、矢状面髋、踝关节总活动度显著相关。意义：分流术后髋、踝关节推进力恢复。Evans指数的正常化可以预测iNPH分流术后推进力的改善。
Background: A few previous studies have reported a change in gait motion in idiopathic normal pressure hydrocephalus (iNPH) patients after shunt surgery compared with before shunt surgery; however, there has been no detailed quantitative investigation of gait, including kinetic and kinematic parameters. Furthermore, the relationship between gait parameters and magnetic resonance (MR) imaging has not been confirmed.Research question: We investigated the gait motion in patients with iNPH, and evaluated the relationship between kinetic gait parameters and MR imaging before and after shunt surgery.Methods: The subjects were 12 patients with iNPH who could walk 10m without aids. A three-dimensional motion analysis system was used to obtain the spatiotemporal, kinetic, and kinematic parameters before and after surgery. Relationships between each gait parameter and MR imaging were assessed.Results: The post-shunt walking speed and step length were increased compared with pre-shunt values. The post-shunt evaluation showed increased range of motion of the hip, knee, and ankle joints in the sagittal plane during the gait cycle. The peak flexion moment of the hip during the stance phase was greater after shunt surgery. The improvement rate of the Evans index was significantly correlated with the improvement rate of walking speed, and the total ranges of motion of the hip and ankle joints in the sagittal plane.Significance: The propulsive force of the hip and ankle joints was regained after shunt surgery. Normalization of the Evans index could predict improvement in propulsive force after shunt surgery in iNPH.