![]() ![]() Since improvement is seen predominately in gait function, outcome assessment in this domain is especially important. The Mini Mental State Examination (MMSE) is commonly used for assessment of cognitive function. For assessment of function in activities of daily living the modified Rankin scale (mRS), which is an ordinal scale, is commonly used although mRS was not developed for iNPH. However, drawbacks are that these scales are time consuming, might require several specialists to complete and are generally blunt when assessing minor improvement. Composite scales based on several of these measures, such as the iNPH scale, have been introduced in attempts to give a more comprehensive description of the full clinical picture. To assess preoperative levels of the cardinal symptoms as well as post-operative outcome, different scales or other measures of gait, balance control, cognition, incontinence, and activities of daily living are used. The disorder is treated by shunt surgery, and if carefully selected, 70–80% of patients improve after surgery, mainly in their gait and balance but also in cognitive function and urinary continence. In persons aged 65 years and older the prevalence has been found to be in the range of 1.3–4%. iNPH usually presents in elderly individuals. Idiopathic normal pressure hydrocephalus (iNPH) is a syndrome characterised by a triad of gait and balance disturbance, cognitive impairment, and urinary incontinence. 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. TUG performance is associated with performance on the 10MWT pre- and post-operatively. 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 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). Worse preoperative TUG and younger age favoured improvement. TUG time and steps were higher in women compared to men (p < 0.001) but there was no sex difference in improvement rate. Post-operatively, significant improvements to 14.0 s and 19 steps were seen. Preoperative TUG values were 19.0 s (median ) and 23 steps. Data were dichotomised by sex, age, and preoperative TUG time. Clinical scales were examined pre- and 3 months post-operatively. All data were retrieved from the SHQR except the 10MWT, which was collected from patient medical records. Patients with iNPH (n = 1300), registered in the Swedish Hydrocephalus Quality Registry (SHQR), were included. 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. These findings should help clinicians and researchers determine whether a change in an individual patient with PD is a true change.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. The results showed that the TUG and the DGI have generally acceptable random measurement error and test-retest reliability. The study sample was a convenience sample, and the participants had mild to moderately severe PD. The test-retest reliability values for the TUG and the DGI were high the intraclass correlation coefficients were. The respective MDC and MDC% of the TUG were 3.5 seconds and 29.8, and those of the DGI were 2.9 points and 13.3. Furthermore, the intraclass correlation coefficient was used to examine the reproducibility between testing sessions (test-retest reliability). The percentage MDC (MDC%) was calculated as the MDC divided by the mean of all scores for the sample. The MDC was calculated from the standard error of measurement. All participants completed the TUG and the DGI assessments twice, about 14 days apart. Their mean age was 67.5 years, and 61% were men. Seventy-two participants were recruited from special clinics for movement disorders at a university hospital. This investigation was a prospective cohort study. The purpose of this study was to estimate the MDCs of the TUG and the DGI in people with PD. The MDCs of the Timed "Up & Go" Test (TUG) and the Dynamic Gait Index (DGI) in people with Parkinson disease (PD) are largely unknown, limiting the interpretability of the change scores of both measures. The minimal detectable change (MDC) is the smallest amount of difference in individual scores that represents true change (beyond random measurement error). ![]()
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