Department of Radiation Sciences, Radiation Physics, Biomedical Engineering, Umeå University, Umeå, Sweden.
Department of Activity and Health, and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.
Fluids Barriers CNS. 2022 Jan 10;19(1):4. doi: 10.1186/s12987-021-00298-5.
The aim of this study was to describe the outcome measure timed up and go (TUG) in a large, nationwide cohort of patients with idiopathic normal pressure hydrocephalus (iNPH) pre- and post-operatively. Furthermore, to compare the TUG test to the 10-m walk test (10MWT), the iNPH scale, the modified Rankin scale (mRS) and the Mini Mental State Examination (MMSE), which are commonly applied in clinical assessment of iNPH.
Patients with iNPH (n = 1300), registered in the Swedish Hydrocephalus Quality Registry (SHQR), were included. All data were retrieved from the SHQR except the 10MWT, which was collected from patient medical records. Clinical scales were examined pre- and 3 months post-operatively. Data were dichotomised by sex, age, and preoperative TUG time.
Preoperative TUG values were 19.0 [14.0-26.0] s (median [IQR]) and 23 [18-30] steps. Post-operatively, significant improvements to 14.0 [11.0-20.0] s and 19 [15-25] steps were seen. TUG time and steps were higher in women compared to men (p < 0.001) but there was no sex difference in improvement rate. Worse preoperative TUG and younger age favoured improvement. TUG was highly correlated to the 10MWT, but correlations of post-operative changes were only low to moderate between all scales (r = 0.22-0.61).
This study establishes the distribution of TUG in iNPH patients and shows that the test captures important clinical features that improve after surgery independent of sex and in all age groups, confirming the clinical value of the TUG test. TUG performance is associated with performance on the 10MWT pre- and post-operatively. However, the weak correlations in post-operative change to the 10MWT and other established outcome measures indicate an additional value of TUG when assessing the effects of shunt surgery.
本研究旨在描述特发性正常压力脑积水（iNPH）患者术前和术后大量全国性队列的计时起立行走测试（TUG）结果。此外，将 TUG 测试与 10 米步行测试（10MWT）、iNPH 量表、改良 Rankin 量表（mRS）和简易精神状态检查（MMSE）进行比较，这些测试常用于 iNPH 的临床评估。
纳入了瑞典脑积水质量登记处（SHQR）登记的 iNPH 患者（n=1300）。除了从患者病历中收集的 10MWT 外，所有数据均从 SHQR 中检索。术前和术后 3 个月检查临床量表。数据按性别、年龄和术前 TUG 时间进行二分法。
术前 TUG 值为 19.0[14.0-26.0]s（中位数[IQR]）和 23[18-30]步。术后 TUG 时间显著改善至 14.0[11.0-20.0]s 和 19[15-25]步。女性的 TUG 时间和步数高于男性（p<0.001），但改善率无性别差异。术前 TUG 较差和年龄较小有利于改善。TUG 与 10MWT 高度相关，但所有量表术后变化之间的相关性仅为低到中度（r=0.22-0.61）。
本研究确立了 iNPH 患者 TUG 的分布，并表明该测试可捕获与手术相关的重要临床特征，且这些特征在独立于性别和所有年龄组中都有所改善，证实了 TUG 测试的临床价值。TUG 表现与术前和术后 10MWT 表现相关。然而，10MWT 和其他既定结局指标的术后变化相关性较弱，表明 TUG 在评估分流手术效果时具有额外价值。
