{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T02:26:01Z","timestamp":1787192761445,"version":"build-2736575974"},"reference-count":32,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T00:00:00Z","timestamp":1787097600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T00:00:00Z","timestamp":1787097600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["movementdisorders.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Movement Disord Clin Pract"],"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n Falls are a significant cause of morbidity in idiopathic normal pressure hydrocephalus (iNPH), yet the specific motor domains driving fall occurrence and fall frequency remain uncharacterized.<\/jats:p>\n <\/jats:sec>\n \n Objectives<\/jats:title>\n The aim is to identify specific motor profiles associated with fall occurrence versus fall frequency in iNPH, and to evaluate relationships between cerebrospinal fluid (CSF) drainage trial responsiveness and shunt surgery outcomes.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n We retrospectively analyzed 323 patients with possible or probable iNPH. Fall history and multi\u2010domain motor assessments (gait speed, endurance, and balance) were evaluated pre\u2010 and post\u2010CSF drainage. Multivariable regression assessed domain\u2010specific fall risk and continuous factors correlating with post\u2010surgical gait improvement in shunted patients (n\u2009=\u2009117).<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Greater endurance and leg strength independently predicted a lower likelihood of experiencing any fall (\n P<\/jats:italic>\n \u2009<\u20090.05). Conversely, a higher frequency of recurrent falls was associated with broader motor deterioration, including slower dynamic mobility and reduced static balance (\n P<\/jats:italic>\n \u2009<\u20090.001). Regarding surgical outcomes, greater baseline severity and drainage trial responsiveness in dynamic speed tests independently correlated with the magnitude of long\u2010term post\u2010surgical recovery (\n P<\/jats:italic>\n \u2009<\u20090.05).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n A functional dissociation exists in the iNPH motor presentation which is that fall occurrence links to strength and endurance deficits, whereas a higher number of falls is driven by degraded complex balance. Multi\u2010domain assessments effectively stratify patient\u2010specific fall risk, whereas dynamic speed best correlates with surgical recovery.<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/mdc3.70789","type":"journal-article","created":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T02:21:01Z","timestamp":1787192461000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Multi\u2010Domain Gait Profiling in Idiopathic Normal Pressure Hydrocephalus: Differentiating Fall Patterns and Assessing Shunt Responsiveness"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3903-8343","authenticated-orcid":false,"given":"Siavash","family":"Shirzadeh Barough","sequence":"first","affiliation":[{"name":"Department of Neurology Johns Hopkins University School of Medicine Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara G.","family":"Ho","sequence":"additional","affiliation":[{"name":"Department of Neurology Johns Hopkins University School of Medicine Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gianna","family":"Proscino","sequence":"additional","affiliation":[{"name":"Department of Neurology Johns Hopkins University School of Medicine Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Megha","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Neurology Johns Hopkins University School of Medicine Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5080-6534","authenticated-orcid":false,"given":"Sevil","family":"Yasar","sequence":"additional","affiliation":[{"name":"Department of Neurology Johns Hopkins University School of Medicine Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9464-1551","authenticated-orcid":false,"given":"Abhay","family":"Moghekar","sequence":"additional","affiliation":[{"name":"Department of Neurology Johns Hopkins University School of Medicine Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,19]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1016\/0022-510X(65)90016-X","article-title":"The special clinical problem of symptomatic hydrocephalus with normal cerebrospinal fluid pressure: observations on cerebrospinal fluid hydrodynamics","volume":"2","author":"Hakim S","year":"1965","journal-title":"J Neurol Sci"},{"key":"e_1_2_9_3_1","doi-asserted-by":"crossref","first-page":"S24","DOI":"10.1227\/01.NEU.0000168185.29659.C5","article-title":"Diagnosing idiopathic normal\u2010pressure 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A systemic review","volume":"362","author":"Mihalj M","year":"2016","journal-title":"J Neurol Sci"},{"key":"e_1_2_9_30_1","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1186\/s12987-019-0142-9","article-title":"The Kuopio idiopathic normal pressure hydrocephalus protocol: initial outcome of 175 patients","volume":"16","author":"Junkkari A","year":"2019","journal-title":"Fluids Barriers CNS"},{"key":"e_1_2_9_31_1","doi-asserted-by":"crossref","first-page":"1574","DOI":"10.1002\/mdc3.13816","article-title":"Gait analysis in idiopathic Normal pressure hydrocephalus: a meta\u2010analysis","volume":"10","author":"Passaretti M","year":"2023","journal-title":"Mov Disord Clin Pract"},{"key":"e_1_2_9_32_1","doi-asserted-by":"crossref","DOI":"10.1186\/s12987-022-00350-y","article-title":"Gait apraxia evaluation in normal pressure hydrocephalus using inertial sensors. Clinical correlates, ventriculoperitoneal shunt outcomes, and tap\u2010test predictive capacity","volume":"19","author":"Ferrari A","year":"2022","journal-title":"Fluids Barriers CNS"},{"key":"e_1_2_9_33_1","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1016\/j.parkreldis.2019.07.021","article-title":"A prospective evaluation of clinical and instrumental features before and after ventriculo\u2010peritoneal shunt in patients with idiopathic Normal pressure hydrocephalus: the Bologna PRO\u2010hydro study","volume":"66","author":"Giannini G","year":"2019","journal-title":"Parkinsonism Relat Disord"}],"container-title":["Movement Disorders Clinical Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/movementdisorders.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/mdc3.70789","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/movementdisorders.onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/mdc3.70789","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/movementdisorders.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/mdc3.70789","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T02:21:05Z","timestamp":1787192465000},"score":1,"resource":{"primary":{"URL":"https:\/\/movementdisorders.onlinelibrary.wiley.com\/doi\/10.1002\/mdc3.70789"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,19]]},"references-count":32,"alternative-id":["10.1002\/mdc3.70789"],"URL":"https:\/\/doi.org\/10.1002\/mdc3.70789","archive":["Portico"],"relation":{},"ISSN":["2330-1619","2330-1619"],"issn-type":[{"value":"2330-1619","type":"print"},{"value":"2330-1619","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,19]]},"assertion":[{"value":"2026-06-09","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-06","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-19","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"mdc3.70789"}}