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Gait Assessment Using Three-Dimensional Acceleration of the Trunk in Idiopathic Normal Pressure Hydrocephalus.

YAMADA Shigeki 0000-0001-7158-5569 AOYAGI Yukihiko ISHIKAWA Masatsune 0000-0003-3515-4969 YAMAGUCHI Makoto 0000-0002-0121-2895 YAMAMOTO Kazuo 0000-0003-3983-6916 NOZAKI Kazuhiko 90252452 0000-0003-1623-068X 滋賀医科大学

2021.03.10

概要

Background:
The subjective evaluation of pathological gait exhibits a low inter-rater reliability. Therefore, we developed a three-dimensional acceleration of the trunk during walking to assess the pathological gait quantitatively.
Methods:
We evaluated 97 patients who underwent the cerebrospinal tap test and were diagnosed with idiopathic normal pressure hydrocephalus (iNPH) and 68 healthy elderlies. The gait features of all patients were evaluated and classified as one of the following: freezing of gait, wide-based gait, short-stepped gait, shuffling gait, instability, gait festination, difficulty in changing direction, and balance disorder in standing up. All gait features of 68 healthy elderlies were treated as normal. Trunk acceleration was recorded automatically by a smartphone placed on the umbilicus during a 15-foot walking test. Two novel indices were created. The first index was a trunk acceleration index, which was defined as (forward acceleration fluctuation) + (vertical acceleration fluctuation) - (lateral acceleration fluctuation) based on the multivariate logistics regression model, and the second index was created by multiplying the forward acceleration with the vertical acceleration. Additionally, 95% confidence ellipsoid volume of the three-dimensional accelerations was assessed.
Results:
Forward and vertical acceleration fluctuations were significantly associated with the probability of an iNPH-specific pathological gait. The trunk acceleration index demonstrated the strongest association with the probability of an iNPH-specific pathological gait. The areas under the receiver-operating characteristic curves for detecting 100% probability of an iNPH-specific pathological gait were 86.9% for forward acceleration fluctuation, 88.0% for vertical acceleration fluctuation, 82.8% for lateral acceleration fluctuation, 89.0% for trunk acceleration index, 88.8% for forward × vertical acceleration fluctuation, and 87.8% for 95% confidence ellipsoid volume of the three-dimensional accelerations.
Conclusions:
The probability of a pathological gait specific to iNPH is high at the trunk acceleration fluctuation, reduced in the forward and vertical directions, and increased in the lateral direction.

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Frontiers in Aging Neuroscience | www.frontiersin.org

Conflict of Interest: YA was employed by company Digital Standard Co., Ltd.,

Osaka, Japan.

The remaining authors declare that the research was conducted in the absence of

any commercial or financial relationships that could be construed as a potential

conflict of interest.

Copyright © 2021 Yamada, Aoyagi, Ishikawa, Yamaguchi, Yamamoto and Nozaki.

This is an open-access article distributed under the terms of the Creative Commons

Attribution License (CC BY). The use, distribution or reproduction in other forums

is permitted, provided the original author(s) and the copyright owner(s) are credited

and that the original publication in this journal is cited, in accordance with accepted

academic practice. No use, distribution or reproduction is permitted which does not

comply with these terms.

March 2021 | Volume 13 | Article 653964

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