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Quantitative Evaluation of Gait Disturbance on an Instrumented Timed Up-and-go Test
Shigeki Yamada 1,2,*, Yukihiko Aoyagi 3, Kazuo Yamamoto2, Masatsune Ishikawa1,4
1Normal Pressure Hydrocephalus Center, Rakuwakai Otowa Hospital, Rakuwakai Healthcare System, Kyoto, Japan.
2Department of Neurosurgery and Stroke Center, Rakuwakai Otowa Hospital, Rakuwakai Healthcare System, Kyoto, Japan.
3Digital Standard Co., Ltd., Osaka, Japan.
4Rakuwa Villa Ilios, Rakuwakai Healthcare System, Kyoto, Japan
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Although the 3-m timed up-and-go test (TUG) is reliable for evaluating mobility, TUG time is insufficient to evaluate mild gait disturbance; we, therefore aimed to investigate other measurements with instrumented TUG (iTUG) using a free smartphone application. Our inclusion criterion in this study is only that participants can walk without any assistance. This study included three heterogeneous groups; patients who underwent a tap test or shunt surgery, 29 inpatients hospitalized for other reasons, and 87 day-care users. After the tap test, 28 were diagnosed with tap-positive idiopathic normal-pressure hydrocephalus (iNPH) and 8 were diagnosed with tap-negative. Additionally, 18 patients were assessed iTUG before and after shunt surgery. During iTUG, time and 3-dimensional (3D) acceleration were automatically recorded every 0.01 s. A volume of the 95% confidence ellipsoid (95%CE) of all plots for 3D acceleration was calculated. Additionally, an iTUG score was defined as (95%CE volume) 0.8 / 1.9 - 1.9 × (time) + 60. The measurement reliability was evaluated using intraclass correlations and Bland-Altman plots. The participants with mild gait disturbance who accomplished within 13.5 s on the iTUG time had the 95%CE volumes for 3D acceleration of ≥70 m3/s6 and iTUG scores of ≥50. The mean iTUG time was shortened and the mean 95%CE volumes and iTUG scores were increased after the tap test among 28 patients with tap-positive iNPH and after shunt surgery among 18 patients with definite iNPH. Conversely, the mean iTUG score among 8 patients with tap-negative was decreased after the tap test. The intraclass correlations for the time, 95%CE volume and iTUG score were 0.97, 0.80 and 0.90, respectively. Not only the iTUG time but also the 95%CE volume was important for evaluating mobility. Therefore, the novel iTUG score consisting both is useful for the quantitative assessment of mobility.

Keywords gait disturbance      gait assessment      diagnostic test assessment      timed up-and-go test      idiopathic normal-pressure hydrocephalus      cerebrospinal fluid tap test     
Corresponding Authors: Yamada Shigeki   
Issue Date: 27 December 2017
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Shigeki Yamada
Yukihiko Aoyagi
Kazuo Yamamoto
Masatsune Ishikawa
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Shigeki Yamada,Yukihiko Aoyagi,Kazuo Yamamoto, et al. Quantitative Evaluation of Gait Disturbance on an Instrumented Timed Up-and-go Test[J]. A&D, 10.14336/AD.2018.0426
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