{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T18:18:41Z","timestamp":1792261121051,"version":"4.4.0"},"reference-count":56,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,4]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>Idiopathic normal pressure hydrocephalus (iNPH) results in significant morbidity in the elderly with symptoms of dementia, gait instability, and urinary incontinence. In well-selected patients, ventriculoperitoneal shunt (VPS) placement often results in clinical improvement. Most postshunt assessments of patients rely on subjective scales. The goal of this study was to assess the utility of remote activity monitoring to provide objective evidence of gait improvement following VPS placement for iNPH.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>Patients with iNPH were prospectively enrolled and fitted with 5 activity monitors (on the hip and bilateral thighs and ankles) that they wore for 4 days preoperatively within 30 days of surgery and for 4 days within 30 days postoperatively. Monitors collected continuous data for number of steps, cadence, body position (upright, prone, supine, and lateral decubitus), gait entropy, and the proportion of each day spent active or static. Data were retrieved from the devices and a comparison of pre- and postoperative movement assessment was performed. The gait data were also correlated with formal clinical gait assessments before and after lumbar puncture and with motion analysis laboratory testing at baseline and 1 month and 1 year after VPS placement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Twenty patients fulfilled the inclusion and exclusion criteria (median age 76 years). The baseline median number of daily steps was 1929, the median percentage of the day spent inactive was 70%, the median percentage of the day with a static posture was 95%, the median gait velocity was 0.49 m\/sec, and the median number of steps required to turn was 8. There was objective improvement in median entropy from pre- to postoperatively, increasing from 0.6 to 0.8 (p = 0.002). There were no statistically significant differences for any of the remaining variables measured by the activity monitors when comparing the preoperative to the 1-month postoperative time point. All variables from motion analysis testing showed statistically significant differences or a trend toward significance at 1 year after VPS placement. Among the significantly correlated variables at baseline, cadence was inversely correlated with percentage of gait cycle spent in the support phase (contact with ground vs swing phase).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>This pilot study suggests that activity monitoring provides an early objective measure of improvement in gait entropy after VPS placement among patients with iNPH, although a more significant improvement was noted on the detailed clinical gait assessments. Further long-term studies are needed to determine the utility of remote monitoring for assessing gait improvement following VPS placement.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2023.1.focus22640","type":"journal-article","created":{"date-parts":[[2023,4,1]],"date-time":"2023-04-01T08:25:09Z","timestamp":1680337509000},"page":"E6","source":"Crossref","is-referenced-by-count":4,"title":["Objective assessment of patients with idiopathic normal pressure hydrocephalus following ventriculoperitoneal shunt placement using activity-monitoring data: pilot study"],"prefix":"10.3171","volume":"54","author":[{"given":"Ignacio","family":"Jusue-Torres","sequence":"first","affiliation":[{"name":"Departments of Neurological Surgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Desmond A.","family":"Brown","sequence":"additional","affiliation":[{"name":"National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zach","family":"Pennington","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Petrice M.","family":"Cogswell","sequence":"additional","affiliation":[{"name":"Radiology,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Farwa","family":"Ali","sequence":"additional","affiliation":[{"name":"Neurology, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neill","family":"Graff-Radford","sequence":"additional","affiliation":[{"name":"Department of Neurology, Mayo Clinic, Jacksonville, Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David T.","family":"Jones","sequence":"additional","affiliation":[{"name":"Neurology, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeremy K.","family":"Cutsforth-Gregory","sequence":"additional","affiliation":[{"name":"Neurology, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Graff-Radford","sequence":"additional","affiliation":[{"name":"Neurology, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenton R.","family":"Kaufman","sequence":"additional","affiliation":[{"name":"Biomedical Engineering, Mayo Clinic, Rochester, Minnesota;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin D.","family":"Elder","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"7","key":"b1","series-title":"Nat Clin Pract Neurol","first-page":"375","article-title":"The diagnosis and treatment of idiopathic normal pressure hydrocephalus","volume":"2","author":"Gallia GL","year":"2006","unstructured":"Gallia GL, Rigamonti D, Williams MA. The diagnosis and treatment of idiopathic normal pressure hydrocephalus. Nat Clin Pract Neurol. 2006;2(7):375\u2013381.16932588"},{"issue":"4","key":"b2","series-title":"Observations on cerebrospinal fluid hydrodynamics. J Neurol Sci","first-page":"307","article-title":"The special clinical problem of symptomatic hydrocephalus with normal cerebrospinal fluid pressure","volume":"2","author":"Hakim S","year":"1965","unstructured":"Hakim S, Adams RD. The special clinical problem of symptomatic hydrocephalus with normal cerebrospinal fluid pressure. Observations on cerebrospinal fluid hydrodynamics. J Neurol Sci. 1965;2(4):307\u2013327.5889177"},{"key":"b3","series-title":"N Engl J Med","first-page":"117","article-title":"Symptomatic occult hydrocephalus with \"normal\" cerebrospinal-fluid pressure. A treatable syndrome","volume":"273","author":"Adams RD","year":"1965","unstructured":"Adams RD, Fisher CM, Hakim S, Ojemann RG, Sweet WH. Symptomatic occult hydrocephalus with \"normal\" cerebrospinal-fluid pressure. A treatable syndrome. N Engl J Med. 1965;273:117\u2013126.14303656"},{"issue":"5","key":"b4","series-title":"Neurosurgery","first-page":"1166","article-title":"Idiopathic normal pressure hydrocephalus: a systematic review of diagnosis and outcome","volume":"49","author":"Hebb AO","year":"2001","unstructured":"Hebb AO, Cusimano MD. Idiopathic normal pressure hydrocephalus: a systematic review of diagnosis and outcome. Neurosurgery. 2001;49(5):1166\u20131186.11846911"},{"issue":"2 Dementia","key":"b5","series-title":"Continuum (Minneap Minn)","first-page":"579","article-title":"Diagnosis and treatment of idiopathic normal pressure hydrocephalus","volume":"22","author":"Williams MA","year":"2016","unstructured":"Williams MA, Malm J. Diagnosis and treatment of idiopathic normal pressure hydrocephalus. Continuum (Minneap Minn). 2016;22(2 Dementia):579\u2013599.27042909"},{"issue":"16","key":"b6","series-title":"Neurology","first-page":"1449","article-title":"Prevalence of idiopathic normal-pressure hydrocephalus","volume":"82","author":"Jaraj D","year":"2014","unstructured":"Jaraj D, Rabiei K, Marlow T, Jensen C, Skoog I, Wikkels\u00f8 C. Prevalence of idiopathic normal-pressure hydrocephalus. Neurology. 2014;82(16):1449\u20131454.24682964"},{"key":"b7","series-title":"Acta Neurochir Suppl","first-page":"237","article-title":"Guidelines for management of idiopathic normal pressure hydrocephalus: progress to date","volume":"95","author":"Marmarou A","year":"2005","unstructured":"Marmarou A, Black P, Bergsneider M, Klinge P, Relkin N. Guidelines for management of idiopathic normal pressure hydrocephalus: progress to date. Acta Neurochir Suppl. 2005;95:237\u2013240.16463856"},{"issue":"3)(suppl","key":"b8","series-title":"Neurosurgery","first-page":"S4","article-title":"Diagnosing idiopathic normal-pressure hydrocephalus","volume":"57","author":"Relkin N","year":"2005","unstructured":"Relkin N, Marmarou A, Klinge P, Bergsneider M, Black PM. Diagnosing idiopathic normal-pressure hydrocephalus. Neurosurgery. 2005;57(3)(suppl):S4-S16, ii\u2013v.16160425"},{"issue":"1","key":"b9","series-title":"Neurosurgery","first-page":"80","article-title":"Diagnostic intracranial pressure monitoring and surgical management in idiopathic normal pressure hydrocephalus: a 6-year review of 214 patients","volume":"66","author":"Eide PK","year":"2010","unstructured":"Eide PK, Sorteberg W. Diagnostic intracranial pressure monitoring and surgical management in idiopathic normal pressure hydrocephalus: a 6-year review of 214 patients. Neurosurgery. 2010;66(1):80\u201391.20023540"},{"issue":"6","key":"b10","series-title":"J Neurol Neurosurg Psychiatry","first-page":"778","article-title":"Alzheimer\u2019s disease comorbidity in normal pressure hydrocephalus: prevalence and shunt response","volume":"68","author":"Golomb J","year":"2000","unstructured":"Golomb J, Wisoff J, Miller DC,  Alzheimer\u2019s disease comorbidity in normal pressure hydrocephalus: prevalence and shunt response. J Neurol Neurosurg Psychiatry. 2000;68(6):778\u2013781.10811706"},{"key":"b11","series-title":"Cerebrospinal Fluid Res","first-page":"18","article-title":"Diagnosis of idiopathic normal pressure hydrocephalus is supported by MRI-based scheme: a prospective cohort study","volume":"7","author":"Hashimoto M","year":"2010","unstructured":"Hashimoto M, Ishikawa M, Mori E, Kuwana N. Diagnosis of idiopathic normal pressure hydrocephalus is supported by MRI-based scheme: a prospective cohort study. Cerebrospinal Fluid Res. 2010;7:18.21040519"},{"issue":"suppl","key":"b12","series-title":"Neurol Med Chir (Tokyo)","first-page":"S1","article-title":"Guidelines for management of idiopathic normal pressure hydrocephalus","volume":"48","author":"Ishikawa M","year":"2008","unstructured":"Ishikawa M, Hashimoto M, Kuwana N,  Guidelines for management of idiopathic normal pressure hydrocephalus. Neurol Med Chir (Tokyo). 2008;48(suppl):S1\u2013S23.18408356"},{"issue":"2","key":"b13","series-title":"Dement Neuropsychol","first-page":"133","article-title":"Normal-pressure hydrocephalus: a critical review","volume":"13","author":"Oliveira LM","year":"2019","unstructured":"Oliveira LM, Nitrini R, Rom\u00e1n GC. Normal-pressure hydrocephalus: a critical review. Dement Neuropsychol. 2019;13(2):133\u2013143.31285787"},{"issue":"10","key":"b14","series-title":"Acta Neurochir (Wien)","first-page":"1977","article-title":"Systematic review of the outcome of shunt surgery in idiopathic normal-pressure hydrocephalus","volume":"155","author":"Toma AK","year":"2013","unstructured":"Toma AK, Papadopoulos MC, Stapleton S, Kitchen ND, Watkins LD. Systematic review of the outcome of shunt surgery in idiopathic normal-pressure hydrocephalus. Acta Neurochir (Wien). 2013;155(10):1977\u20131980.23975646"},{"issue":"3","key":"b15","series-title":"J Healthc Qual","first-page":"146","article-title":"Using Charlson Comorbidity Index to predict short-term clinical outcomes in hospitalized older adults","volume":"41","author":"Sinvani L","year":"2019","unstructured":"Sinvani L, Kuriakose R, Tariq S,  Using Charlson Comorbidity Index to predict short-term clinical outcomes in hospitalized older adults. J Healthc Qual. 2019;41(3):146\u2013153.31094947"},{"key":"b16","series-title":"Protokinetics","article-title":"The Zeno\u2122 walkway gait analysis system","unstructured":"The Zeno\u2122 walkway gait analysis system. Protokinetics. Accessed February 10, 2023. https:\/\/www.protokinetics.com\/zeno-walkway\/"},{"key":"b17","unstructured":"GT3X+. Actigraphcorp. Accessed February 10, 2023. https:\/\/actigraphcorp.com\/support\/activity-monitors\/gt3xplus\/"},{"issue":"2","key":"b18","series-title":"Med Eng Phys","first-page":"169","article-title":"Validity of using tri-axial accelerometers to measure human movement\u2014Part I: Posture and movement detection","volume":"36","author":"Lugade V","year":"2014","unstructured":"Lugade V, Fortune E, Morrow M, Kaufman K. Validity of using tri-axial accelerometers to measure human movement\u2014Part I: Posture and movement detection. Med Eng Phys. 2014;36(2):169\u2013176.23899533"},{"issue":"6","key":"b19","series-title":"Med Eng Phys","first-page":"659","article-title":"Validity of using tri-axial accelerometers to measure human movement\u2014Part II: Step counts at a wide range of gait velocities","volume":"36","author":"Fortune E","year":"2014","unstructured":"Fortune E, Lugade V, Morrow M, Kaufman K. Validity of using tri-axial accelerometers to measure human movement\u2014Part II: Step counts at a wide range of gait velocities. Med Eng Phys. 2014;36(6):659\u2013669."},{"key":"b20","year":"2022","unstructured":"R: A Language and Environment for Statistical Computing. R Foundation for Statistical Computing; 2022. Accessed February 10, 2023.https:\/\/www.R-project.org\/"},{"issue":"11","key":"b21","series-title":"Cureus","first-page":"e382","article-title":"Using commercial activity monitors to measure gait in patients with suspected iNPH: implications for ambulatory monitoring","volume":"7","author":"Gaglani S","year":"2015","unstructured":"Gaglani S, Moore J, Haynes MR, Hoffberger JB, Rigamonti D. Using commercial activity monitors to measure gait in patients with suspected iNPH: implications for ambulatory monitoring. Cureus. 2015;7(11):e382.26719825"},{"key":"b22","series-title":"Surg Neurol Int","first-page":"464","article-title":"Using smartphone-based accelerometers to gauge postoperative outcomes in patients with NPH: implications for ambulatory monitoring","volume":"12","author":"Sprau AC","year":"2021","unstructured":"Sprau AC, Basil GW, Eliahu K,  Using smartphone-based accelerometers to gauge postoperative outcomes in patients with NPH: implications for ambulatory monitoring. Surg Neurol Int. 2021;12:464.34621579"},{"issue":"1","key":"b23","series-title":"Fluids Barriers CNS","first-page":"51","article-title":"Gait apraxia evaluation in normal pressure hydrocephalus using inertial sensors. Clinical correlates, ventriculoperitoneal shunt outcomes, and tap-test predictive capacity","volume":"19","author":"Ferrari A","year":"2022","unstructured":"Ferrari A, Milletti D, Palumbo P,  Gait apraxia evaluation in normal pressure hydrocephalus using inertial sensors. Clinical correlates, ventriculoperitoneal shunt outcomes, and tap-test predictive capacity. Fluids Barriers CNS. 2022;19(1):51.35739555"},{"issue":"2)(suppl 2","key":"b24","series-title":"HSS J","first-page":"358","article-title":"Monitoring patient recovery after THA or TKA using mobile technology","volume":"16","author":"Lyman S","year":"2020","unstructured":"Lyman S, Hidaka C, Fields K, Islam W, Mayman D. Monitoring patient recovery after THA or TKA using mobile technology. HSS J. 2020;16(2)(suppl 2):358\u2013365."},{"issue":"3","key":"b25","series-title":"J Phys Ther Sci","first-page":"243","article-title":"Use of the pedometer in the evaluation of the effects of rehabilitation treatment on deambulatory autonomy in patients with lower limb arthroplasty during hospital rehabilitation: long-term postoperative outcomes","volume":"32","author":"Melchiorri G","year":"2020","unstructured":"Melchiorri G, Viero V, Triossi T, Bianchi D, Tancredi V. Use of the pedometer in the evaluation of the effects of rehabilitation treatment on deambulatory autonomy in patients with lower limb arthroplasty during hospital rehabilitation: long-term postoperative outcomes. J Phys Ther Sci. 2020;32(3):243\u2013250.32184541"},{"issue":"12","key":"b26","series-title":"JAMA","first-page":"1151","article-title":"Association of daily step count and step intensity with mortality among US adults","volume":"323","author":"Saint-Maurice PF","year":"2020","unstructured":"Saint-Maurice PF, Troiano RP, Bassett DR Jr,  Association of daily step count and step intensity with mortality among US adults. JAMA. 2020;323(12):1151\u20131160.32207799"},{"issue":"3","key":"b27","series-title":"J Neurol","first-page":"640","article-title":"Survival in treated idiopathic normal pressure hydrocephalus","volume":"267","author":"Andr\u00e9n K","year":"2020","unstructured":"Andr\u00e9n K, Wikkels\u00f8 C, Sundstr\u00f6m N,  Survival in treated idiopathic normal pressure hydrocephalus. J Neurol. 2020;267(3):640\u2013648.31713102"},{"issue":"4","key":"b28","series-title":"Eur J Neurol","first-page":"1153","article-title":"Early shunt surgery improves survival in idiopathic normal pressure hydrocephalus","volume":"28","author":"Andr\u00e9n K","year":"2021","unstructured":"Andr\u00e9n K, Wikkels\u00f8 C, Hellstr\u00f6m P, Tullberg M, Jaraj D. Early shunt surgery improves survival in idiopathic normal pressure hydrocephalus. Eur J Neurol. 2021;28(4):1153\u20131159.33316127"},{"issue":"7","key":"b1","series-title":"Nat Clin Pract Neurol","first-page":"375","article-title":"The diagnosis and treatment of idiopathic normal pressure hydrocephalus","volume":"2","author":"Gallia GL","year":"2006","unstructured":"Gallia GL, Rigamonti D, Williams MA. The diagnosis and treatment of idiopathic normal pressure hydrocephalus. Nat Clin Pract Neurol. 2006;2(7):375\u2013381.16932588"},{"issue":"4","key":"b2","series-title":"Observations on cerebrospinal fluid hydrodynamics. J Neurol Sci","first-page":"307","article-title":"The special clinical problem of symptomatic hydrocephalus with normal cerebrospinal fluid pressure","volume":"2","author":"Hakim S","year":"1965","unstructured":"Hakim S, Adams RD. The special clinical problem of symptomatic hydrocephalus with normal cerebrospinal fluid pressure. Observations on cerebrospinal fluid hydrodynamics. J Neurol Sci. 1965;2(4):307\u2013327.5889177"},{"key":"b3","series-title":"N Engl J Med","first-page":"117","article-title":"Symptomatic occult hydrocephalus with \"normal\" cerebrospinal-fluid pressure. A treatable syndrome","volume":"273","author":"Adams RD","year":"1965","unstructured":"Adams RD, Fisher CM, Hakim S, Ojemann RG, Sweet WH. Symptomatic occult hydrocephalus with \"normal\" cerebrospinal-fluid pressure. A treatable syndrome. N Engl J Med. 1965;273:117\u2013126.14303656"},{"issue":"5","key":"b4","series-title":"Neurosurgery","first-page":"1166","article-title":"Idiopathic normal pressure hydrocephalus: a systematic review of diagnosis and outcome","volume":"49","author":"Hebb AO","year":"2001","unstructured":"Hebb AO, Cusimano MD. Idiopathic normal pressure hydrocephalus: a systematic review of diagnosis and outcome. Neurosurgery. 2001;49(5):1166\u20131186.11846911"},{"issue":"2 Dementia","key":"b5","series-title":"Continuum (Minneap Minn)","first-page":"579","article-title":"Diagnosis and treatment of idiopathic normal pressure hydrocephalus","volume":"22","author":"Williams MA","year":"2016","unstructured":"Williams MA, Malm J. Diagnosis and treatment of idiopathic normal pressure hydrocephalus. Continuum (Minneap Minn). 2016;22(2 Dementia):579\u2013599.27042909"},{"issue":"16","key":"b6","series-title":"Neurology","first-page":"1449","article-title":"Prevalence of idiopathic normal-pressure hydrocephalus","volume":"82","author":"Jaraj D","year":"2014","unstructured":"Jaraj D, Rabiei K, Marlow T, Jensen C, Skoog I, Wikkels\u00f8 C. Prevalence of idiopathic normal-pressure hydrocephalus. Neurology. 2014;82(16):1449\u20131454.24682964"},{"key":"b7","series-title":"Acta Neurochir Suppl","first-page":"237","article-title":"Guidelines for management of idiopathic normal pressure hydrocephalus: progress to date","volume":"95","author":"Marmarou A","year":"2005","unstructured":"Marmarou A, Black P, Bergsneider M, Klinge P, Relkin N. Guidelines for management of idiopathic normal pressure hydrocephalus: progress to date. Acta Neurochir Suppl. 2005;95:237\u2013240.16463856"},{"issue":"3)(suppl","key":"b8","series-title":"Neurosurgery","first-page":"S4","article-title":"Diagnosing idiopathic normal-pressure hydrocephalus","volume":"57","author":"Relkin N","year":"2005","unstructured":"Relkin N, Marmarou A, Klinge P, Bergsneider M, Black PM. Diagnosing idiopathic normal-pressure hydrocephalus. Neurosurgery. 2005;57(3)(suppl):S4-S16, ii\u2013v.16160425"},{"issue":"1","key":"b9","series-title":"Neurosurgery","first-page":"80","article-title":"Diagnostic intracranial pressure monitoring and surgical management in idiopathic normal pressure hydrocephalus: a 6-year review of 214 patients","volume":"66","author":"Eide PK","year":"2010","unstructured":"Eide PK, Sorteberg W. Diagnostic intracranial pressure monitoring and surgical management in idiopathic normal pressure hydrocephalus: a 6-year review of 214 patients. Neurosurgery. 2010;66(1):80\u201391.20023540"},{"issue":"6","key":"b10","series-title":"J Neurol Neurosurg Psychiatry","first-page":"778","article-title":"Alzheimer\u2019s disease comorbidity in normal pressure hydrocephalus: prevalence and shunt response","volume":"68","author":"Golomb J","year":"2000","unstructured":"Golomb J, Wisoff J, Miller DC,  Alzheimer\u2019s disease comorbidity in normal pressure hydrocephalus: prevalence and shunt response. J Neurol Neurosurg Psychiatry. 2000;68(6):778\u2013781.10811706"},{"key":"b11","series-title":"Cerebrospinal Fluid Res","first-page":"18","article-title":"Diagnosis of idiopathic normal pressure hydrocephalus is supported by MRI-based scheme: a prospective cohort study","volume":"7","author":"Hashimoto M","year":"2010","unstructured":"Hashimoto M, Ishikawa M, Mori E, Kuwana N. Diagnosis of idiopathic normal pressure hydrocephalus is supported by MRI-based scheme: a prospective cohort study. Cerebrospinal Fluid Res. 2010;7:18.21040519"},{"issue":"suppl","key":"b12","series-title":"Neurol Med Chir (Tokyo)","first-page":"S1","article-title":"Guidelines for management of idiopathic normal pressure hydrocephalus","volume":"48","author":"Ishikawa M","year":"2008","unstructured":"Ishikawa M, Hashimoto M, Kuwana N,  Guidelines for management of idiopathic normal pressure hydrocephalus. Neurol Med Chir (Tokyo). 2008;48(suppl):S1\u2013S23.18408356"},{"issue":"2","key":"b13","series-title":"Dement Neuropsychol","first-page":"133","article-title":"Normal-pressure hydrocephalus: a critical review","volume":"13","author":"Oliveira LM","year":"2019","unstructured":"Oliveira LM, Nitrini R, Rom\u00e1n GC. Normal-pressure hydrocephalus: a critical review. Dement Neuropsychol. 2019;13(2):133\u2013143.31285787"},{"issue":"10","key":"b14","series-title":"Acta Neurochir (Wien)","first-page":"1977","article-title":"Systematic review of the outcome of shunt surgery in idiopathic normal-pressure hydrocephalus","volume":"155","author":"Toma AK","year":"2013","unstructured":"Toma AK, Papadopoulos MC, Stapleton S, Kitchen ND, Watkins LD. Systematic review of the outcome of shunt surgery in idiopathic normal-pressure hydrocephalus. Acta Neurochir (Wien). 2013;155(10):1977\u20131980.23975646"},{"issue":"3","key":"b15","series-title":"J Healthc Qual","first-page":"146","article-title":"Using Charlson Comorbidity Index to predict short-term clinical outcomes in hospitalized older adults","volume":"41","author":"Sinvani L","year":"2019","unstructured":"Sinvani L, Kuriakose R, Tariq S,  Using Charlson Comorbidity Index to predict short-term clinical outcomes in hospitalized older adults. J Healthc Qual. 2019;41(3):146\u2013153.31094947"},{"key":"b16","series-title":"Protokinetics","article-title":"The Zeno\u2122 walkway gait analysis system","unstructured":"The Zeno\u2122 walkway gait analysis system. Protokinetics. Accessed February 10, 2023. https:\/\/www.protokinetics.com\/zeno-walkway\/"},{"key":"b17","unstructured":"GT3X+. Actigraphcorp. Accessed February 10, 2023. https:\/\/actigraphcorp.com\/support\/activity-monitors\/gt3xplus\/"},{"issue":"2","key":"b18","series-title":"Med Eng Phys","first-page":"169","article-title":"Validity of using tri-axial accelerometers to measure human movement\u2014Part I: Posture and movement detection","volume":"36","author":"Lugade V","year":"2014","unstructured":"Lugade V, Fortune E, Morrow M, Kaufman K. Validity of using tri-axial accelerometers to measure human movement\u2014Part I: Posture and movement detection. Med Eng Phys. 2014;36(2):169\u2013176.23899533"},{"issue":"6","key":"b19","series-title":"Med Eng Phys","first-page":"659","article-title":"Validity of using tri-axial accelerometers to measure human movement\u2014Part II: Step counts at a wide range of gait velocities","volume":"36","author":"Fortune E","year":"2014","unstructured":"Fortune E, Lugade V, Morrow M, Kaufman K. Validity of using tri-axial accelerometers to measure human movement\u2014Part II: Step counts at a wide range of gait velocities. Med Eng Phys. 2014;36(6):659\u2013669."},{"key":"b20","year":"2022","unstructured":"R: A Language and Environment for Statistical Computing. R Foundation for Statistical Computing; 2022. Accessed February 10, 2023.https:\/\/www.R-project.org\/"},{"issue":"11","key":"b21","series-title":"Cureus","first-page":"e382","article-title":"Using commercial activity monitors to measure gait in patients with suspected iNPH: implications for ambulatory monitoring","volume":"7","author":"Gaglani S","year":"2015","unstructured":"Gaglani S, Moore J, Haynes MR, Hoffberger JB, Rigamonti D. Using commercial activity monitors to measure gait in patients with suspected iNPH: implications for ambulatory monitoring. Cureus. 2015;7(11):e382.26719825"},{"key":"b22","series-title":"Surg Neurol Int","first-page":"464","article-title":"Using smartphone-based accelerometers to gauge postoperative outcomes in patients with NPH: implications for ambulatory monitoring","volume":"12","author":"Sprau AC","year":"2021","unstructured":"Sprau AC, Basil GW, Eliahu K,  Using smartphone-based accelerometers to gauge postoperative outcomes in patients with NPH: implications for ambulatory monitoring. Surg Neurol Int. 2021;12:464.34621579"},{"issue":"1","key":"b23","series-title":"Fluids Barriers CNS","first-page":"51","article-title":"Gait apraxia evaluation in normal pressure hydrocephalus using inertial sensors. Clinical correlates, ventriculoperitoneal shunt outcomes, and tap-test predictive capacity","volume":"19","author":"Ferrari A","year":"2022","unstructured":"Ferrari A, Milletti D, Palumbo P,  Gait apraxia evaluation in normal pressure hydrocephalus using inertial sensors. Clinical correlates, ventriculoperitoneal shunt outcomes, and tap-test predictive capacity. Fluids Barriers CNS. 2022;19(1):51.35739555"},{"issue":"2)(suppl 2","key":"b24","series-title":"HSS J","first-page":"358","article-title":"Monitoring patient recovery after THA or TKA using mobile technology","volume":"16","author":"Lyman S","year":"2020","unstructured":"Lyman S, Hidaka C, Fields K, Islam W, Mayman D. Monitoring patient recovery after THA or TKA using mobile technology. HSS J. 2020;16(2)(suppl 2):358\u2013365."},{"issue":"3","key":"b25","series-title":"J Phys Ther Sci","first-page":"243","article-title":"Use of the pedometer in the evaluation of the effects of rehabilitation treatment on deambulatory autonomy in patients with lower limb arthroplasty during hospital rehabilitation: long-term postoperative outcomes","volume":"32","author":"Melchiorri G","year":"2020","unstructured":"Melchiorri G, Viero V, Triossi T, Bianchi D, Tancredi V. Use of the pedometer in the evaluation of the effects of rehabilitation treatment on deambulatory autonomy in patients with lower limb arthroplasty during hospital rehabilitation: long-term postoperative outcomes. J Phys Ther Sci. 2020;32(3):243\u2013250.32184541"},{"issue":"12","key":"b26","series-title":"JAMA","first-page":"1151","article-title":"Association of daily step count and step intensity with mortality among US adults","volume":"323","author":"Saint-Maurice PF","year":"2020","unstructured":"Saint-Maurice PF, Troiano RP, Bassett DR Jr,  Association of daily step count and step intensity with mortality among US adults. JAMA. 2020;323(12):1151\u20131160.32207799"},{"issue":"3","key":"b27","series-title":"J Neurol","first-page":"640","article-title":"Survival in treated idiopathic normal pressure hydrocephalus","volume":"267","author":"Andr\u00e9n K","year":"2020","unstructured":"Andr\u00e9n K, Wikkels\u00f8 C, Sundstr\u00f6m N,  Survival in treated idiopathic normal pressure hydrocephalus. J Neurol. 2020;267(3):640\u2013648.31713102"},{"issue":"4","key":"b28","series-title":"Eur J Neurol","first-page":"1153","article-title":"Early shunt surgery improves survival in idiopathic normal pressure hydrocephalus","volume":"28","author":"Andr\u00e9n K","year":"2021","unstructured":"Andr\u00e9n K, Wikkels\u00f8 C, Hellstr\u00f6m P, Tullberg M, Jaraj D. Early shunt surgery improves survival in idiopathic normal pressure hydrocephalus. Eur J Neurol. 2021;28(4):1153\u20131159.33316127"}],"container-title":["Neurosurgical Focus"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/neurosurg-focus\/54\/4\/article-pE6.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/neurosurg-focus\/54\/4\/article-pE6.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/neurosurg-focus\/54\/4\/article-pE6.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,6]],"date-time":"2026-06-06T08:13:49Z","timestamp":1780733629000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/neurosurg-focus\/54\/4\/article-pE6.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,4]]},"references-count":56,"journal-issue":{"issue":"4"},"URL":"https:\/\/doi.org\/10.3171\/2023.1.focus22640","relation":{},"ISSN":["1092-0684"],"issn-type":[{"value":"1092-0684","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,4]]}}}