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Aiding diagnosis of normal pressure hydrocephalus with enhanced gait feature separability

Published: 23 October 2012 Publication History

Abstract

Normal Pressure Hydrocephalus (NPH) is a neurological condition that challenges differential diagnosis, as the symptoms -- cognitive and gait impairment and urinary incontinence -- are similar to those of many aging disorders, including Alzheimer's disease and other forms of dementia. Since NPH is caused by abnormal accumulation of cerebrospinal fluid (CSF) around the brain, a high volume lumbar puncture (HVLP) to remove excess fluid is used as the stimulus for a suspected NPH patient, and a diagnosis is made based on the observed cognitive and functional response.
Gait features have long been used as functional indicators in the pre- and post-HVLP assessment. However, these assessments are limited to visual observation in the clinic. Therefore, only simple gait features such as walking speed (based on time to walk 10m) and average stride length/time (based on the number of steps to walk 10m) are used. However, these features provide limited separability in the NPH diagnosis.
This paper presents methods for enhanced diagnostic separability using additional gait features extracted from an inertial body sensor network (BSN), including stride time variability, double support time, and stability. A pilot study on six HVLP patients -- four of whom were ultimately diagnosed with NPH -- revealed that gait stability assessed by Lyapunov exponent provides better separability and can enhance the differential diagnosis. In addition, these results suggest that additional testing can be performed continuously outside of the clinic to account for patients' variable HVLP response times.

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  • (2021)DAid pressure socks system: Performance evaluationGait & Posture10.1016/j.gaitpost.2021.01.00784(368-376)Online publication date: Feb-2021
  • (2017)Quantifying Variation in Gait Features from Wearable Inertial Sensors Using Mixed Effects ModelsSensors10.3390/s1703046617:3(466)Online publication date: 25-Feb-2017
  • (2016)Toward Pervasive Gait Analysis With Wearable Sensors: A Systematic ReviewIEEE Journal of Biomedical and Health Informatics10.1109/JBHI.2016.260872020:6(1521-1537)Online publication date: Nov-2016
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        cover image ACM Other conferences
        WH '12: Proceedings of the conference on Wireless Health
        October 2012
        117 pages
        ISBN:9781450317603
        DOI:10.1145/2448096
        Permission to make digital or hard copies of all or part of this work for personal or classroom use is granted without fee provided that copies are not made or distributed for profit or commercial advantage and that copies bear this notice and the full citation on the first page. Copyrights for components of this work owned by others than ACM must be honored. Abstracting with credit is permitted. To copy otherwise, or republish, to post on servers or to redistribute to lists, requires prior specific permission and/or a fee. Request permissions from [email protected]

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        Published: 23 October 2012

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        Author Tags

        1. Lyapunov exponent
        2. diagnosis
        3. evaluation
        4. gait features
        5. gait stability
        6. inertial BSN
        7. normal pressure hydrocephalus

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        WH '12
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        WH '12: Wireless Health 2012
        October 23 - 25, 2012
        California, San Diego

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        View all
        • (2021)DAid pressure socks system: Performance evaluationGait & Posture10.1016/j.gaitpost.2021.01.00784(368-376)Online publication date: Feb-2021
        • (2017)Quantifying Variation in Gait Features from Wearable Inertial Sensors Using Mixed Effects ModelsSensors10.3390/s1703046617:3(466)Online publication date: 25-Feb-2017
        • (2016)Toward Pervasive Gait Analysis With Wearable Sensors: A Systematic ReviewIEEE Journal of Biomedical and Health Informatics10.1109/JBHI.2016.260872020:6(1521-1537)Online publication date: Nov-2016
        • (2016)Causality Analysis of Inertial Body Sensors for Multiple Sclerosis Diagnostic EnhancementIEEE Journal of Biomedical and Health Informatics10.1109/JBHI.2016.258990220:5(1273-1280)Online publication date: Sep-2016

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