ArticleFluids and barriers of the CNS2026
Sensitivity of physiotherapy-based clinical tests in detecting change in gait and balance performance following a 50 mL CSF tap test in idiopathic normal pressure hydrocephalus.
Article in Fluids and barriers of the CNS, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Sensor-derived heel pressure metrics capture reversible gait dysfunction beyond conventional gait measures in normal pressure hydrocephalus.Journal of neuroengineering and rehabilitation · 2026Observational
- Clinical characteristics and outcomes after shunt surgery in idiopathic normal pressure hydrocephalus with or without prior cerebrospinal fluid tap testing: a single-center follow-up study of 481 patients.Fluids and barriers of the CNS · 2026Article
- 6-minute walk test and the 3-metre backward walk test are sensitive to postoperative gait improvement in idiopathic normal pressure hydrocephalus.BMJ neurology open · 2026Article
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4 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundCerebrospinal fluid tap test (CSF TT) is a key predictive method commonly used to identify candidates for shunt surgery in idiopathic Normal Pressure Hydrocephalus (iNPH), however, the sensitivity of this procedure is limited. The aim was to compare sensitivity of a broad set of physiotherapy-based clinical tests for assessing changes following CSF TT in a group of selected iNPH patients and to explore potential sex-based differences in the responses.
methodsNinety-five selected iNPH patients (mean age 77, SD 6, 57% male), underwent CSF TT prior to shunt surgery. Clinical tests comprised different static balance tests in varying conditions including feet and heels apart and together; eyes open and closed; on floor and foam cushion, followed by gait and functional performance measures including 10-meter walk test (10MWT), 3-meter backward walking (3MBW), Timed-up and Go (TUG) and 6-minute walking test (6MWT). Duration in seconds (sec) and distance were noted. Assessments were conducted at set time points before and after the drainage procedure. Changes in performance were analyzed, and responses compared between sexes.
resultsSignificant increase was observed across most static balance tests except tandem eyes closed (EC) and one-legged stance tests. The largest enhancements were seen in the Romberg test (4.9 s), followed by foam cushion-eyes open (EO) tests (feet together: 3.9 s and heels together: 3.8 s), heels together-EC (3.8 s) and tandem-EO (3.1 s). Gait and functional tests significantly improved (p < 0.001) and 3MBW showed the largest change, with a 32% reduction in sec and a 23% reduction in steps, followed by decrease in TUG sec (27%) and 10-MWT sec (21%), and 6MWT distance increase (25%). Males demonstrated significant increase in heels together-EO and feet together-EO duration which were not observed in females; after adjusting for baseline performances, no significant sex-related differences in responsiveness to CSF TT were found.
conclusionsChallenging comprehensive physiotherapy tests, including gait assessments in direction and capacity, such as 3MBW and 6MWT, together with postural control evaluations using foam cushion and tandem stance increases the sensitivity to change and are suggested to be used to detect functional changes after CSF TT in patients with iNPH. TRAIL REGISTRATION: The project is registered in "FoU inSweden” (Research and Development in Sweden) ID: 285356.
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