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Cognitive and upper limb symptom changes from a tap test in Idiopathic Normal Pressure Hydrocephalus.
Clin Neurol Neurosurg 2018; 174:92-96CN

Abstract

OBJECTIVES

To determine which cognitive and upper limb assessments can identify change in patients undergoing a Cerebrospinal fluid (CSF) tap test (TT) diagnosed with idiopathic Normal Pressure Hydrocephalus (iNPH).

PATIENTS AND METHODS

Prospective observational study of 74 iNPH patients undergoing a CSF TT for consideration of a ventricular peritoneal shunt. Patients who were offered surgical intervention were classified as responders. Patients were assessed with a battery of cognitive and upper limb assessments prior to and following a CSF TT. The Timed up and go cognition (TUG-C), Montreal Cognitive assessment (MoCA) and 9-hole peg test were utilised.

RESULTS

40 patients were classified responders. Significant differences were identified for responders for the MoCA (0.62 points) and TUG-C (-6.02 s). Only the executive function and orientation sub scores of the MoCA showed significant changes for responders. The 9 hole peg test mean change of 4.33 s for responders was not significant. Non-responder change scores for the MoCA (0.22 points), TUG-C (0.3 s) and 9 hole peg test (2.58 s) were not significant.

CONCLUSION

The TUG-C has the potential to identify change in patients resulting from a CSF TT. While statistically significant change was found for the MoCA, a mean change of less than 1 point on this scale is unlikely to be clinically relevant. Similarly, the 9 hole peg test cannot be endorsed as an assessment tool for identifying changed performance in iNPH.

Authors+Show Affiliations

John Hunter Hospital Physiotherapy Department, Hunter New England Local Health District, Newcastle, Australia; School of Health Sciences, The University of Newcastle, Newcastle, Australia; Hunter Medical Research Institute, Newcastle, Australia. Electronic address: Ryan.gallagher@hnehealth.nsw.gov.au.School of Health Sciences, The University of Newcastle, Newcastle, Australia; Hunter Medical Research Institute, Newcastle, Australia.School of Health Sciences, The University of Newcastle, Newcastle, Australia.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

30219624

Citation

Gallagher, Ryan M., et al. "Cognitive and Upper Limb Symptom Changes From a Tap Test in Idiopathic Normal Pressure Hydrocephalus." Clinical Neurology and Neurosurgery, vol. 174, 2018, pp. 92-96.
Gallagher RM, Marquez J, Osmotherly P. Cognitive and upper limb symptom changes from a tap test in Idiopathic Normal Pressure Hydrocephalus. Clin Neurol Neurosurg. 2018;174:92-96.
Gallagher, R. M., Marquez, J., & Osmotherly, P. (2018). Cognitive and upper limb symptom changes from a tap test in Idiopathic Normal Pressure Hydrocephalus. Clinical Neurology and Neurosurgery, 174, pp. 92-96. doi:10.1016/j.clineuro.2018.09.015.
Gallagher RM, Marquez J, Osmotherly P. Cognitive and Upper Limb Symptom Changes From a Tap Test in Idiopathic Normal Pressure Hydrocephalus. Clin Neurol Neurosurg. 2018;174:92-96. PubMed PMID: 30219624.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cognitive and upper limb symptom changes from a tap test in Idiopathic Normal Pressure Hydrocephalus. AU - Gallagher,Ryan M, AU - Marquez,Jodie, AU - Osmotherly,Peter, Y1 - 2018/09/10/ PY - 2017/12/18/received PY - 2018/08/19/revised PY - 2018/09/08/accepted PY - 2018/9/17/pubmed PY - 2018/9/17/medline PY - 2018/9/17/entrez KW - Idiopathic Normal Pressure Hydrocephalus KW - Occupational therapy KW - Physiotherapy KW - Tap test SP - 92 EP - 96 JF - Clinical neurology and neurosurgery JO - Clin Neurol Neurosurg VL - 174 N2 - OBJECTIVES: To determine which cognitive and upper limb assessments can identify change in patients undergoing a Cerebrospinal fluid (CSF) tap test (TT) diagnosed with idiopathic Normal Pressure Hydrocephalus (iNPH). PATIENTS AND METHODS: Prospective observational study of 74 iNPH patients undergoing a CSF TT for consideration of a ventricular peritoneal shunt. Patients who were offered surgical intervention were classified as responders. Patients were assessed with a battery of cognitive and upper limb assessments prior to and following a CSF TT. The Timed up and go cognition (TUG-C), Montreal Cognitive assessment (MoCA) and 9-hole peg test were utilised. RESULTS: 40 patients were classified responders. Significant differences were identified for responders for the MoCA (0.62 points) and TUG-C (-6.02 s). Only the executive function and orientation sub scores of the MoCA showed significant changes for responders. The 9 hole peg test mean change of 4.33 s for responders was not significant. Non-responder change scores for the MoCA (0.22 points), TUG-C (0.3 s) and 9 hole peg test (2.58 s) were not significant. CONCLUSION: The TUG-C has the potential to identify change in patients resulting from a CSF TT. While statistically significant change was found for the MoCA, a mean change of less than 1 point on this scale is unlikely to be clinically relevant. Similarly, the 9 hole peg test cannot be endorsed as an assessment tool for identifying changed performance in iNPH. SN - 1872-6968 UR - https://www.unboundmedicine.com/medline/citation/30219624/Cognitive_and_upper_limb_symptom_changes_from_a_tap_test_in_Idiopathic_Normal_Pressure_Hydrocephalus_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0303-8467(18)30377-9 DB - PRIME DP - Unbound Medicine ER -