Objective: Parkinson’s disease (PD) and normal pressure hydrocephalus (NPH) cause gait and balance problems, which often lead to falls. The mechanisms responsible for gait and balance impairment in these disorders are different and lead to varying disease courses. The relative weight of these deficits in early disease course has not been studied comparatively before.

Background: Aim is to investigate gait and balance in patients with newly diagnosed NPH and PD comparatively.

Method: Gait and balance were assessed in patients NPH (n=13), with PD (n=20) and healthy controls (n=13) using three IMU sensors (APDM Inc., OR, USA) placed on feet and lumbar area. Balance was evaluated with: modified clinical test of sensory interaction on balance (mCTSIB) test; feet together eyes open or closed; tandem stance on the right foot front, or left foot front; and timed-up and go (TUG). For gait analysis, patients performed 10-Meter Walk Test (10 MWT) and 2 Minutes-Walk Test (2 MWT).

Results: NPH patients exhibited decreased gait speed (p=0.001) and stride length (p= 0.0004) compared to PD and HCs. Tandem stance tasks were associated with NPH group (Chi-square df 12.02, 2 p=0.002 for right foot front; 15.07, 2 p=0.0005 for left foot front). During eyes open tasks on firm surface and foam, PD and NPH groups showed an increase in RMS sway, range and mean velocity (p<0.05) in the anteroposterior plane. Moreover, TUG completion time was significantly increased (p=0.01), and turn velocity was decreased (p=0.03) in the NPH group.

Conclusion: Postural and dynamic balance is affected more severely in patients with NPH compared to PD. Balance should also be evaluated and treated in these patients.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/comparative-assessment-of-gait-and-balance-in-patients-with-parkinsons-disease-and-normal-pressure-hydrocephalus/