基于足底压力的特发性正常压力脑积水步态障碍时间分析：一项初步纵向研究的结果。
Plantar pressure-based temporal analysis of gait disturbance in idiopathic normal pressure hydrocephalus: Indications from a pilot longitudinal study.
机构信息
College of Artificial Intelligence, Nankai University, Tianjin 300350, China; Tianjin Key Laboratory of Intelligent Robotics, Nankai University, Tianjin 300350, China.
Department of Neurosurgery, Tianjin Huanhu Hospital, Tianjin 300350, China.
出版信息
Comput Methods Programs Biomed. 2022 Apr;217:106691. doi: 10.1016/j.cmpb.2022.106691. Epub 2022 Feb 7.
BACKGROUND AND OBJECTIVE
Idiopathic normal pressure hydrocephalus (iNPH) is a common yet potentially reversible neurodegenerative disease, and gait disturbance is a major symptom. Lots of methodological and clinical work has been conducted on gait disturbance analysis for differential diagnosis, presurgical test, and postsurgery assessment of iNPH. Nevertheless, the verification analysis was mostly lacking for surgery response, and the temporal characteristics of ground reaction force has been rarely investigated.
METHODS
In this work, we propose that plantar pressure features fundamentally signifies iNPH gait disturbance and improvement after cerebrospinal fluid (CSF) drainage by lumbar puncture tap test as well as surgical shunt implantation. The plantar pressure signals of six iNPH patients and eight healthy controls were collected, and an online database of sixteen healthy controls were used. For patients, data were collected in five periods, which are the baseline before the tap test, 8, 24, and 72 hours after the tap test, and one month after the shunt implantation surgery, respectively. Fast dynamic time warping (DTW) with an improved DTW barycenter averaging (DBA) method was proposed for temporal analysis with the measured and online plantar pressure data. An plantar-pressure variation index (PPVI) was formulated to characterize the temporal dynamic stability of walking.
RESULTS
The PPVI based on temporal analysis of plantar pressure well discriminated the impaired gait (baseline, 24 and 72 hours after tap test) with the improved gait (8 hours after tap test and follow up after surgery) of the patients. Further, the PPVI was close for the improved gait of the patients and the healthy gait measured in our study as well as in the online database.
CONCLUSIONS
Plantar pressure-based temporal features are promisingly effective for clinical examination and treatment of iNPH.
背景与目的
特发性正常压力脑积水（iNPH）是一种常见但具有潜在可逆转性的神经退行性疾病，步态障碍是其主要症状。针对 iNPH 的鉴别诊断、术前测试和术后评估，已经开展了大量的方法学和临床工作来对步态障碍进行分析。然而，对于手术反应的验证分析大多缺乏，而且很少研究地面反力的时间特征。
方法
在这项工作中，我们提出足底压力特征从根本上表明了 iNPH 步态障碍，并通过腰椎穿刺引流 taps 试验以及手术分流植入改善了步态。收集了六名 iNPH 患者和八名健康对照者的足底压力信号，并使用十六名健康对照者的在线数据库。对于患者，数据分别在五个时期采集，即 taps 试验前的基线、 taps 试验后 8、24 和 72 小时以及分流植入手术后一个月。提出了快速动态时间 warping（DTW）与改进的 DTW 重心平均（DBA）方法相结合的时间分析，用于测量和在线足底压力数据的时间分析。制定了足底压力变化指数（PPVI）来描述行走的时间动态稳定性。
结果
基于足底压力的时间分析的 PPVI 很好地区分了患者受损的步态（基线、taps 试验后 24 和 72 小时）和改善的步态（taps 试验后 8 小时和手术后随访）。此外，PPVI 与患者的改善步态以及我们研究中以及在线数据库中测量的健康步态接近。
结论
基于足底压力的时间特征对于 iNPH 的临床检查和治疗具有很大的应用潜力。
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