Table 5.

Evaluation of gait parameters after VP shunt surgery

Study	Methods of gait assessment	Functional gait tests (mean ± standard deviation; p value)	Spatio-temporal parameters (mean ± standard deviation; p value)	Kinematic/kinetic parameters (mean ± standard deviation; p value)
Chen et al., 2018 [31]	Optoelectronic motion analysis system (Vicon 370)	–	No changes in speed L/R Before-after shunt: 0.34 ± 0.11/0.35 ± 0.13–0.35 ± 0.13/0.34 ± 0.13 m/s ↓ Cadence L/R Before-after shunt: 129.93 ± 9.87/126.12 ± 7.45–99.40 ± 3.71 99.92 ± 3.81 steps/min; p < 0.05 ↑ Stride length L/R Before-after shunt: 0.10 ± 0.02/ 0.11 ± 0.03–0.20 ± 0.07/ 0.20 ± 0.08 m; p < 0.05 ↑ Single support time L/R Before-after shunt: 35.66 ± 5.27/ 35.24 ± 5.09–42.47 ± 4.22/ 41.54 ± 4.11%; p < 0.05 ↓ Double support time L/R Before-after shunt (%): 32.61 ± 3.12/ 32.41 ± 2.98–26.55 ± 2.98/26.16 ± 2.55%; p < 0.05	–
Nikaido et al., 2018 [32]	Triaxial accelerometer	–	↑ Speed SMD: 0.58 (95% CI: [− 0.24–− 0.09] m/s; p = 0.004 ↓ Step count SMD: 0.51 (95% CI: [3.77–12.34] step; p = 0.010 ↓ Stride time SMD: 0.66 (95% CI: [0.01–0.05] s; p = 0.008 ↓Variability in stride time SMD: 0.88 (95% CI: [2.59–7.60] %; p < 0.001	− 7.66 s (95% C.I. [− 9.47, − 6.09] s, mean before-after shunt: 24.07–16.41 s); p < 0.05 -
Kitade et al., 2018 [33]	Optoelectronic motion analysis system (Vicon MX)	–	↑ Speed 0.45 ± 0.19–0.65 ± 0.22 m/s; p < 0.001 ↑ Stride length 0.27 ± 0.12–0.40 ± 0.13 m; p < 0.001 ↑ Cadence 99.9 ± 11.1–110.2 ± 11.0 steps/min; p < 0.05	↑ ROM in the sagittal plane Hip 28.5 ± 8.9–31.7 ± 8.0°; p < 0.01 Knee 35.5 ± 13.2–39.4 ± 10.2°; p < 0.05 Ankle 18.3 ± 5.5–22.7 ± 6.3°; p < 0.001 ↑Hip extension angle before-after shunt:  − 0.41 ± 0.34–− 0.59 ± 0.50 Nm/kg; p < 0.01 ↑ Peak absorption power of the hip (terminal stance phase)   − 0.2 ± 0.3– − 0.4 ± 0.4 W/kg; p < 0.01 ↑ Peak flexion moment of the hip (pre-swing phase) before-after shunt:  − 0.41 ± 0.34–− 0.59 ± 0.50 Nm/kg; p < 0.01 Ankle (flat foot phase) before-after shunt: 0.8 ± 6.9–− 3.4 ± 5.5°; p < 0.001 ↑Peak generation power before-after shunt: Hip 0.3 ± 0.3–0.5 ± 0.6 W/kg; p < 0.05 Ankle 0.9 ± 0.9 W/kg–1.4 ± 1.3 W/kg, p < 0.05 ↑Peak absorption power of the knee (pre-swing phase) before-after shunt:  − 0.4 ± 0.5– − 0.7 ± 0.7 W/kg; p < 0.05 No change in peak extension moment of the knee (Pre-swing phase) before-after shunt: 43.9 ± 12.0–44.1 ± 12.7°; p = 0.93
Song et al., 2019 [34]	ProtoKinetics Zeno walkway	No changes in time score (TUG, 25 walkway) p = 0.0868, p = 0.1067	↑ Speed (cm/s) Average difference 15.6660; p < 0.0001 ↑ Stride length (cm) Average difference 15.0531; p < 0.0001 ↑ Single support time (%) Average difference 1.4096; p < 0.0001 ↑ Swing phase time (%) Average difference 3.9922; p = 0.0136 No changes in cadence (steps/min) Average difference 0.7683; p = 0.3524	No changes in toe in/out angle (°) Average difference −0.8190; p = 0.9166 No change in step width (cm) Average difference 1.3353; p = 0.4247
Giannini et al., 2019 [23]	Instrumented gait analysis	Before-after shunt: ↓ Time score (18 MWT) 31.28 ± 14.90–27.18 ± 11.43 s; p = 0.0008 ↓ Step count (18 MWT) 39.91 ± 16.51–35.03 ± 9.19 steps; p = 0.0146 ↓ Time score (TUG) 22.28 ± 12.86–15.21 ± 4.45 s; p = 0.0034 ↓ Step count (TUG) 25.03 ± 10.78—18.21 ± 4.70 steps; p = 0.0093 No changes in turn steps (TUG) 2.44 ± 1.48–1.85 ± 0.56 step; p = 0.0757	↑ Speed (TUG) 52.53 ± 20.24–62.67 ± 18.68 cm/s; p < 0.0001 ↑ Stride length (TUG) 63.89 ± 21.79–77.55 ± 16.59 cm; p < 0.0001 ↑ Cadence (TUG) 48.30 ± 8.76–52.17 ± 7.66 steps/min; p = 0.0219 ↑ Speed (18MWT) 75.84 ± 22.48–84.61 ± 23.06 cm/s; p < 0.0001 ↑ Stride length (18MWT) 88.66 ± 22.61–97.87 ± 22.17 cm; p = 0.0086 No changes in cadence (18MWT) 50.81 ± 7.97–53.36 ± 6.54 steps/min; p = 0.0694	–
Baltateanu et al., 2019 [35]	Instrumented Gait Analysis	↓ Time score (TUG) 37.68–24.42 s	↑ Speed (10 MWT) 523–734 mm/s	–
Sun et al., 2020 [26]	Plantar pressure-based temporal analysis (Podomed)	–	No changes before-after shunt: Speed 0.46 ± 0.20–0.57 ± 0.25 m/s; p = 0.421 Cadence 102.29 ± 14.87–107.68 ± 15.41 steps/min; p = 1.000 Stride time 1.21 ± 0.19–1.13 ± 0.15 s; p = 0.841 Single support time 66.59 ± 3.02–69.79 ± 4.47%; p = 0.222 Double support time 30.57 ± 6.19–29.23 ± 5.51%; p = 0.421	–
Sundström et al., 2022 [36]	Instrumented gait analysis	↓ Time score (TUG) before-after shunt: 22.2 ± 12.1–16.9 ± 9.2 s; p < 0.001 ↓ Time score (10 MWT) before-after shunt: 16.8 ± 9.8–13.1 ± 5.9 s; p < 0.001	–	–
Gago et al., 2022 [37]	Inertial sensors Physilog®	–	↑ Speed before-after shunt: 0.60 ± 0.28–0.82 ± 0.24 m/s; p < 0.028 ↑ Stride length before-after shunt: 0.66 ± 0.27–0.89 ± 0.25 m; p < 0.027 No changes in double support time Before-after shunt: 33.77 ± 10.62–26.97 ± 5.83%; p = 0.107	–
Hülser et al., 2022 [38]	Instrumented gait analysis	↓ Time score (10 MWT) Before-after shunt:17.1 ± 7.5–11.9 ± 5.1 s; p < 0.009 ↓ Step count (10 MWT) Before-after shunt: 25.0 ± 6.4–18.5 ± 5.6 steps; p < 0.001	–	–
Matsuoka et al., 2022 [30]	Instrumented gait analysis	↓ Time score (TUG) Before-after shunt: 25.5 ± 17.5–18.2 ± 12.8 s; p < 0.007 ↓ Time score (10 MWT comf./max.) Before-after shunt: 22.4 ± 12.9–16.3 ± 10.1/20.6 ± 15.7–14.4 ± 9.7 s; p < 0.000/p < 0.024 ↓ Step count (10 MWT comf./max.) Before-after shunt: 35.3 ± 17.1–28.5 ± 16.0/5.6 ± 23.8–27.3 ± 16.1 s; p < 0.002/p < 0.035	–	–
Hallqvist et al. 2022 [39]	Instrumented gait analysis	↓ Time score (TUG) Before-after shunt:19 (7.2–187)–15.25 (7.6–128) s; p < 0.0001 ↓ Step count (TUG) Before-after shunt: 23 (12–210)–21 (13–100) steps; p < 0.0001	↑ Speed (10 MWT) Before-after shunt: 0.72 (0.1–1.33)–0.9 (0.25–1.49) m/s; p < 0.0001	–
Ferrari et al., 2022 [40]	Inertial sensors mGAIT	↓Time score TUG  − 7.66 (95% C.I. [− 9.47,− 6.09] s, mean before-after shunt: 24.07–16.41 s); p < 0.05 ↓Time score 18MWT − 8.1 (95% C.I. [− 10.62, − 5.73] s, mean before-after shunt: 33.85–25.76 s); p < 0.05	–	–
Giannini et al., 2023 [7]	Instrumented gait analysis	↓ Time score (TUG) Before-after shunt: 2.79 (1.57–4.25)–4.45 (1.81–6.8) delta; p < 0.001	–	–