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. 2009 Dec 7;14 Suppl 4(Suppl 4):53-8.
doi: 10.1186/2047-783x-14-s4-53.

Analysis of postural sway in patients with normal pressure hydrocephalus: effects of shunt implantation

L Czerwosz  1 , E Szczepek, J W Blaszczyk, B Sokolowska, K Dmitruk, K Dudzinski, J Jurkiewicz, Z Czernicki
Affiliations

Analysis of postural sway in patients with normal pressure hydrocephalus: effects of shunt implantation

L Czerwosz et al. Eur J Med Res. .

Abstract

Poor postural balance is one of the major risk factors for falling in normal pressure hydrocephalus (NPH). Postural instability in the clinic is commonly assessed based upon force platform posturography. In this study we focused on the identification of changes in sway characteristics while standing quiet in patients with NPH before and after shunt implantation. Postural sway area and sway radius were analyzed in a group of 9 patients and 46 controls of both genders. Subject's spontaneous sway was recorded while standing quiet on a force platform for 30-60 s, with eyes open and then closed. Both analyzed sway descriptors identified between-group differences and also an effect of shunt implantation in the NPH group. Sway radius and sway area in patients exhibited very high values compared with those in the control group. Importantly, the effect of eyesight in patients was not observed before shunt implantation and reappeared after the surgical treatment. The study documents that static force platform posturography may be a reliable measure of postural control improvement due to shunt surgery.

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Figures

Figure 1
Figure 1
Posturogram measured before shunt implantation with eyes open (EO) and closed (EC) in a normal pressure hydrocephalus (NPH) patient.
Figure 2
Figure 2
Posturogram recorded in the NPH patient shown in Fig. 1 after shunt implantation. EO - eyes open, EC - eyes closed.
Figure 3
Figure 3
Individual and mean values of the sway Radius measured with eyes open (EO) and closed (EC) in NPH patients before and after operation.
Figure 4
Figure 4
Individual and mean values of the sway Area with eyes open (EO) and closed (EC) in NPH patients before and after operation.
Figure 5
Figure 5
Effects of visual conditions on the sway Radius in control and NPH patient groups before and after operation. The upper panels show individual values of the Radius for each subject in either group measured with eyes open (EO) and closed (EC). The bottom columns express differences between the respective EC-EO values.
Figure 6
Figure 6
Effects of visual stimulus on Area values in control and NPH patient group before operation and after operation. The upper panels shows individual values of Area for each subject in either group measured with eyes open (EO) and closed (EC). The bottom columns express differences between the respective EC-EO values.
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