Predictive value of three-dimensional gait parameters for the efficacy of ventriculoperitoneal shunt in normal pressure hydrocephalus

Zhang Xuewen; Huang Yulun; Zhu Haiping; Li Xuetao; Bao Zhen; Zhao Jiashuo

doi:10.11850/j.issn.1009-122X.2025.06.004

Abstract：Objective To explore the preoperative assessment methods for patients with primary normal pressure hydrocephalus(NPH)and predict the effectiveness of ventriculoperitoneal shunt(V-P shunt)surgery.Methods The clinical data of 35 patients with NPH were analyzed retrospectively.After admission,patients underwent three-dimensional gait analysis(including stride frequency,gait speed,stride length,swing phase,and double support phase),Mini-Mental State Examination(MMSE)scoring,and urinary incontinence scoring,followed by a continuous lumbar drainage trial with approximately 150 ml drained daily.After 2 days,the lumbar drain was removed,and the above evaluations were repeated.Based on the reference values of these three indicators before and after the continuous lumbar drainage trial,patients underwent V-P shunt surgery.Postoperative evaluations,including three-dimensional gait analysis,MMSE scoring,and urinary incontinence scoring,were performed at 7,30 and 90 days after V-P shunt surgery to assess treatment efficacy.Results In patients with effective V-P shunt outcomes,significant improvements were observed in stride frequency,gait speed,stride length,and double support phase before and after the lumbar drainage trial(all P<0.05).The swing phase showed no significant improvement during the lumbar drainage trial but demonstrated marked improvement at 7,30 and 90 days post-V-P shunt surgery(all P<0.05).Statistical analysis revealed that the predictive value of three-dimensional gait analysis was superior to that of MMSE score alone,urinary incontinence score alone,or their combined analysis.However,its predictive accuracy was equivalent to that of three-dimensional gait analysis combined with MMSE score or urinary incontinence score.Conclusions Three-dimensional gait analysis before and after the continuous lumbar drainage trial may provide valuable objective reference indicators for predicting the efficacy of V-P shunt surgery in NPH patients.