The Japanese Journal of Rehabilitation Medicine
Online ISSN : 1881-8560
Print ISSN : 1881-3526
ISSN-L : 1881-3526

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Assessment of Relationship between In-hospital Rehabilitation Period after Cerebrospinal Shunt Surgery and Improvement of Gait Disturbance in Idiopathic Normal Pressure Hydrocephalus Patients with Severe Gait Disturbance
Hachirou MoriguchiAoi YokouchiMasatsune IshikawaShigeki Yamada
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JOURNAL RESTRICTED ACCESS Advance online publication

Article ID: 19017

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Abstract

Objective:Currently, there is no reliable evidence on the usefulness of rehabilitation for idiopathic, normal-pressure hydrocephalus (iNPH)patients after cerebrospinal shunt surgery. Therefore, in this study we investigated the association between the duration of rehabilitation and outcomes.

Methods:We evaluated the changes before and after cerebrospinal shunt surgery and rehabilitation by applying the 3-m timed up-and-go test (TUG), 10-m straight walk test, 180-degree turn, 30-seconds chair-stand test (CS-30), mini-mental state examination (MMSE), and frontal assessment battery (FAB) in 81 patients with iNPH. Clinical outcomes were classified as excellent, good, or unsatisfactory.

Results:At discharge, TUG, 180-degree turn, and CS-30 were significantly improved in 38 patients who had been in rehabilitation for ≥2 weeks, compared to those with <2 weeks-rehabilitation after shunt surgery. However, there was no significant difference between MMSE and FAB tests in the two groups. Rehabilitation for ≥2 weeks significantly improved the patient outcome, especially for those patients with severe gait disturbance before treatment. In 53 patients whose initial TUG time was ≥13.5 s, rehabilitation for ≥2 weeks was effective, and resulted in an excellent outcome (odds ratio:4.52, 95% confidence interval:1.22-18.7, P value:0.012).

Conclusion:In-hospital rehabilitation after cerebrospinal shunt surgery was useful for patients with iNPH and severe disability in daily activities. Therefore, we suggest that these patients require in-hospital rehabilitation after shunt surgery until sufficient improvement of gait disturbance is achieved, in order to maximize activities of daily living.

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© 2020 The Japanese Association of Rehabilitation Medicine

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https://creativecommons.org/licenses/by-nc-nd/4.0/deed.ja
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