{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T17:03:22Z","timestamp":1770743002819,"version":"3.49.0"},"reference-count":56,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2025,4,18]],"date-time":"2025-04-18T00:00:00Z","timestamp":1744934400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["movementdisorders.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Movement Disord Clin Pract"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Falls along with gait\u2010balance disturbances are important symptoms of idiopathic normal pressure hydrocephalus (iNPH).<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>This study aimed to validate the Functional Gait Assessment (FGA) item\u2010difficulty hierarchy, determine its optimal fall cutoff value, and identify key items for assessing fall risk in iNPH.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>One hundred eighty\u2010eight iNPH patients underwent pre\u2010intervention assessments using the FGA, timed up\u2010and\u2010go (TUG), 10\u2010Meter Gait Speed (10MGS) tests, and their falls history in the past 6\u2009months. Rasch analysis confirmed the validity of the FGA item\u2010difficulty hierarchy and established the relationship between total scores and logit estimates. Logistic regression identified the optimal FGA cutoff value and key fall\u2010related items.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The FGA's item\u2010difficulty hierarchy was confirmed to range from item 5 (\u201cgait and pivot turn\u201d) at \u22122.58 logits (easiest) to item 7 (\u201cgait with narrow base of support\u201d) at 5.35 logits (most difficult). Total scores corresponded to logits from \u221210.39 (score 0) to 11.64 (score 30). The fall rate was 63.3%. The optimal FGA cutoff value was \u226415 points (area under curve [AUC]: 0.901, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001), outperforming TUG (AUC: 0.712) and 10MGS (AUC: 0.742). Key fall\u2010related items (R<jats:sup>2<\/jats:sup>: 0.545, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001) were item 2 (\u201cchange in gait speed\u201d), item 7 (\u201cgait with narrow base of support\u201d), item 1 (\u201cgait on level surface\u201d), item 10 (\u201cstair steps\u201d), and item 5 (\u201cgait and pivot turn\u201d).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our findings may facilitate early diagnosis and timely interventions, including tailored rehabilitation and fall prevention strategies, by leveraging the item difficulty and characteristics of the FGA for iNPH patients.<\/jats:p><\/jats:sec>","DOI":"10.1002\/mdc3.70084","type":"journal-article","created":{"date-parts":[[2025,4,18]],"date-time":"2025-04-18T06:39:57Z","timestamp":1744958397000},"page":"1264-1274","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Role of the Functional Gait Assessment in Validating Item Difficulty Hierarchy and Fall Risk for Idiopathic Normal Pressure Hydrocephalus"],"prefix":"10.1002","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5250-9023","authenticated-orcid":false,"given":"Yasutaka","family":"Nikaido","sequence":"first","affiliation":[{"name":"Clinical Department of Rehabilitation Osaka Medical and Pharmaceutical University Hospital  Osaka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4038-8655","authenticated-orcid":false,"given":"Hideyuki","family":"Urakami","sequence":"additional","affiliation":[{"name":"Clinical Department of Rehabilitation Osaka Medical and Pharmaceutical University Hospital  Osaka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naoya","family":"Ishida","sequence":"additional","affiliation":[{"name":"Clinical Department of Rehabilitation Osaka Medical and Pharmaceutical University Hospital  Osaka 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