AUTHOR=Oebel Kathrin , Moeller Tobias , Etingold Julie , Brombach Till , Aslam Sana , Hoskin Justin L. , Geda Yonas E. , Woll Alexander , Krell-Roesch Janina TITLE=Physical activity and gait in patients with idiopathic normal pressure hydrocephalus: a literature review JOURNAL=Frontiers in Neurology VOLUME=Volume 16 - 2025 YEAR=2025 URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2025.1501709 DOI=10.3389/fneur.2025.1501709 ISSN=1664-2295 ABSTRACT=BackgroundIdiopathic normal pressure hydrocephalus (iNPH) is characterized by impaired gait and cognition, and urinary incontinence. Even though iNPH still lacks standardized diagnostic criteria, many patients may potentially benefit from treatment which are often invasive procedures.ObjectivesTo provide an overview of the current state of research on physical activity behavior and gait in patients with iNPH, and examine potential changes after treatment (i.e., shunt surgery, spinal tap test or lumbar drainage).MethodsThis literature review was carried out based on the PRISMA statement and we searched PubMed, Web of Science and Scopus databases in April 2023.ResultsIn total, 32 studies were included: 29 focusing on gait, 2 focusing on gait and physical activity, and 1 focusing on physical activity. All studies reported improvements in gait, such as reduced gait ataxia or shuffling gait and greater variability of gait cycle length, after an intervention or treatment. Improvements may depend on patients’ age, symptom duration, and treatment method, among others.ConclusionImprovements in gait after iNPH treatment (e.g., shunt surgery) are well documented, whereas results on physical activity behavior in iNPH patients are inconsistent. More research on physical activity and gait outcomes before and after treatment is needed, also with regard to treatment success.