Emerging Role of Portable Accelerometers for Assessment of Gait Instability in Idiopathic Normal Pressure Hydrocephalus: A Systematic Review.

BackgroundIdiopathic normal pressure hydrocephalus (iNPH) is a reversible cause of gait disturbance, cognitive decline, and urinary incontinence in older adults. Early detection with shunt surgery can significantly improve symptoms.MethodsA systematic review following PRISMA guidelines evaluated the role of portable and smartphone-based accelerometers in quantifying gait parameters in iNPH.ResultsAcross 32 studies, 22 different accelerometers were used, ranging from wearable inertial sensors to smartphone applications. The Three-Dimensional Pose Tracker for Gait Test (TDPT-GT) app was the most frequently utilized, enabling detection of pathological gait features such as shuffling, short steps, and wide-based walking. The G-Walk device was commonly used in clinical assessments, including before and after CSF tap tests. Several studies integrated accelerometry with machine-learning models, improving differentiation of iNPH from other neurological gait disorders.ConclusionPortable accelerometry offers an accessible, objective tool for diagnosis, monitoring, and prognostication in iNPH, with growing potential for routine clinical integration.