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Galeoto G, Berardi A, Simeon R, Panuccio F, Fabbrini G, Belvisi D, González-Bernal J, Seco-Calvo JÁ. Psychometric Properties of Jebsen Taylor Hand Function Test in an Italian Population with Parkinson's Disease. Healthcare (Basel) 2024; 12:1351. [PMID: 38998884 PMCID: PMC11241389 DOI: 10.3390/healthcare12131351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2024] [Revised: 06/28/2024] [Accepted: 07/04/2024] [Indexed: 07/14/2024] Open
Abstract
BACKGROUND Assessment of upper limb function is critical in the rehabilitation process of people with Parkinson's Disease (PD), and universally validated outcome measures are needed to allow comparisons across the practice. Moreover, the study of psychometric properties of the same tool on different clinical populations guarantees the possibility of reliably evaluating the same rehabilitation treatment in people with different clinical conditions. AIM OF THE STUDY The aim of this research was to evaluate the psychometric characteristics of the Italian adaptation of the Jebsen Taylor Hand Function Test (JTHFT) in individuals with PD. METHODS The reliability and validity of the test were assessed in accordance with international standards. Internal consistency was measured using Cronbach's alpha, and test-retest reliability was determined via the intraclass correlation coefficient (ICC). The construct validity and cross-cultural validity of the test were evaluated using Pearson's correlation coefficient with three assessment tools on upper limb function, independence, and quality of life, with hand grip power measured by a dynamometer and an Italian pangram. Finally, responsiveness after a one month of rehabilitation treatment was measured using the Wilcoxon rank test. RESULTS Fifty-two Italian people with PD were recruited. Cronbach's alpha values ranged from 0.556 (non-dominant hand) to 0.668 (dominant hand); ICC values ranged from 0.754 to 0.988. Construct validity showed that several statistically significant correlations were detected. Wilcoxon's test showed that the assessment tool can detect a change in this population after treatment. CONCLUSIONS The JTHFT is a reliable, valid, and respondent tool to evaluate the upper limb and hand functionalities in PD patients. It should be added to the toolkit for measuring upper limb performance in this population, adding value to clinical evaluation and ensuring comparable results for different clinical populations and different countries.
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Affiliation(s)
- Giovanni Galeoto
- Department of Human Neurosciences, Sapienza University of Rome, 00185 Rome, Italy; (A.B.); (R.S.); (F.P.); (G.F.); (D.B.)
- IRCSS Neuromed, Via Atinense, 18, 86077 Pozzilli, Italy
- Department of Nursing and Physical Therapy, Institute of Biomedicine (IBIOMED), University of León, 24071 León, Spain;
| | - Anna Berardi
- Department of Human Neurosciences, Sapienza University of Rome, 00185 Rome, Italy; (A.B.); (R.S.); (F.P.); (G.F.); (D.B.)
- IRCSS Neuromed, Via Atinense, 18, 86077 Pozzilli, Italy
- Department of Nursing and Physical Therapy, Institute of Biomedicine (IBIOMED), University of León, 24071 León, Spain;
| | - Rachele Simeon
- Department of Human Neurosciences, Sapienza University of Rome, 00185 Rome, Italy; (A.B.); (R.S.); (F.P.); (G.F.); (D.B.)
| | - Francescaroberta Panuccio
- Department of Human Neurosciences, Sapienza University of Rome, 00185 Rome, Italy; (A.B.); (R.S.); (F.P.); (G.F.); (D.B.)
| | - Giovanni Fabbrini
- Department of Human Neurosciences, Sapienza University of Rome, 00185 Rome, Italy; (A.B.); (R.S.); (F.P.); (G.F.); (D.B.)
- IRCSS Neuromed, Via Atinense, 18, 86077 Pozzilli, Italy
| | - Daniele Belvisi
- Department of Human Neurosciences, Sapienza University of Rome, 00185 Rome, Italy; (A.B.); (R.S.); (F.P.); (G.F.); (D.B.)
- IRCSS Neuromed, Via Atinense, 18, 86077 Pozzilli, Italy
| | | | - Jesús Ángel Seco-Calvo
- Department of Nursing and Physical Therapy, Institute of Biomedicine (IBIOMED), University of León, 24071 León, Spain;
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Pisaltu S, Ruotolo I, Sellitto G, Berardi A, Simeon R, Fabbrini G, Galeoto G. Validity and reliability of the Italian version of the short Parkinson's evaluation scale (SPES/SCOPA). Heliyon 2024; 10:e32877. [PMID: 39021984 PMCID: PMC11253227 DOI: 10.1016/j.heliyon.2024.e32877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Revised: 06/10/2024] [Accepted: 06/11/2024] [Indexed: 07/20/2024] Open
Abstract
Background In the medical and rehabilitative field, it is essential to employ tools such as evaluation scales and performance tests to assess the impact of Parkinson's disease on QoL of affected individuals. The Short Parkinson's Evaluation Scale (SPES) is a reliable and valid tool, applicable both in research and clinical practices, useful in assessing motor damage, activities of daily living, and motor complications in patients with Parkinson's disease. The aim of the study is to investigate validity and reliability of the Italian version of the SPES-SCOPA scale. Methods Translation and cultural adaptation were performed. Included patients had diagnosis of Parkinson's disease, no concurrent pathologies, MiniMental test score above 2 and signed informed consent; they were recruited at the Department of Human Neurosciences in Sapienza University of Rome, from February 2023 to November 2023. Test-retest reliability was evaluated through Intraclass Correlation Coefficient (ICC), internal consistency was assessed using Cronbach's Alpha and construct validity using Pearson's correlation between SPES-SCOPA and the gold standard PDQ-39. Results 101 patients were recruited. Inter-rater evaluation was conducted on 62 patients, while 39 underwent an intra-rater assessment. The analysis showed statistically significant data with a Cronbach's Alpha value of 0.89 for the entire scale; test-retest reliability results are statistically significant for all subscales. Correlation between PDQ-39 domains and SPES/SCOPA subscales were statistically significant for most measurements. Conclusion This research shows that the Italian version of SPES-SCOPA scale has excellent psychometric properties.
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Affiliation(s)
| | - I. Ruotolo
- Sapienza University of Rome, Department of Human Neuroscience, 00185, Rome, Italy
| | - G. Sellitto
- Sapienza University of Rome, Department of Human Neuroscience, 00185, Rome, Italy
| | - A. Berardi
- Sapienza University of Rome, Department of Human Neuroscience, 00185, Rome, Italy
| | - R. Simeon
- Sapienza University of Rome, Department of Human Neuroscience, 00185, Rome, Italy
| | - G. Fabbrini
- Sapienza University of Rome, Department of Human Neuroscience, 00185, Rome, Italy
- IRCCS Neuromed, Via Atinense, 18, 86077, Pozzilli, IS, Italy
| | - G. Galeoto
- Sapienza University of Rome, Department of Human Neuroscience, 00185, Rome, Italy
- IRCCS Neuromed, Via Atinense, 18, 86077, Pozzilli, IS, Italy
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Capato TTC, Rodrigues R, Cury RG, Teixeira MJ, Barbosa ER. Clinical assessment of upper limb impairments and functional capacity in Parkinson's disease: a systematic review. ARQUIVOS DE NEURO-PSIQUIATRIA 2023; 81:1008-1015. [PMID: 37899049 PMCID: PMC10689111 DOI: 10.1055/s-0043-1772769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 07/19/2023] [Indexed: 10/31/2023]
Abstract
BACKGROUND Parkinson's disease (PD) may progressively reduce the upper limb's functionality. Currently, there is no standardized upper limb functional capacity assessment in PD in the rehabilitation field. OBJECTIVE To identify specific outcome measurements to assess upper limbs in PD and access functional capacity. METHODS We systematically reviewed and analyzed the literature in English published from August/2012 to August/2022 according to PRISMA. The following keywords were used in our search: "upper limbs" OR "upper extremity" and "Parkinson's disease." Two researchers searched independently, including studies accordingly to our inclusion and exclusion criteria. Registered at PROSPERO CRD42021254486. RESULTS We found 797 studies, and 50 were included in this review (n = 2.239 participants in H&Y stage 1-4). The most common upper limbs outcome measures found in the studies were: (i) UPDRS-III and MDS-UPDRS to assess the severity and progression of PD motor symptoms (tremor, bradykinesia, and rigidity) (ii) Nine Hole Peg Test and Purdue Pegboard Test to assess manual dexterity; (iii) Spiral test and Funnel test to provoke and assess freezing of upper limbs; (iv) Technology assessment such as wearables sensors, apps, and other device were also found. CONCLUSION We found evidence to support upper limb impairments assessments in PD. However, there is still a large shortage of specific tests to assess the functional capacity of the upper limbs. The upper limbs' functional capacity is insufficiently investigated during the clinical and rehabilitation examination due to a lack of specific outcome measures to assess functionality.
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Affiliation(s)
- Tamine T. C. Capato
- Universidade de São Paulo, Faculdade de Medicina, Departamento de Neurologia, Centro de Distúrbios do Movimento, São Paulo SP, Brazil.
- Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behavior, Department of Neurology, Nijmegen, The Netherlands.
| | - Rúbia Rodrigues
- Universidade de São Paulo, Faculdade de Medicina, Departamento de Neurologia, Centro de Distúrbios do Movimento, São Paulo SP, Brazil.
| | - Rubens G. Cury
- Universidade de São Paulo, Faculdade de Medicina, Departamento de Neurologia, Centro de Distúrbios do Movimento, São Paulo SP, Brazil.
| | | | - Egberto R. Barbosa
- Universidade de São Paulo, Faculdade de Medicina, Departamento de Neurologia, Centro de Distúrbios do Movimento, São Paulo SP, Brazil.
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Walz ID, Waibel S, Kuhner A, Gollhofer A, Maurer C. Age-related changes in mobility assessments correlate with repetitive goal-directed arm-movement performance. BMC Geriatr 2023; 23:487. [PMID: 37568095 PMCID: PMC10422784 DOI: 10.1186/s12877-023-04150-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 07/04/2023] [Indexed: 08/13/2023] Open
Abstract
BACKGROUND There is ample evidence that mobility abilities between healthy young and elderly people differ. However, we do not know whether these differences are based on different lower leg motor capacity or instead reveal a general motor condition that could be detected by monitoring upper-limb motor behavior. We therefore captured body movements during a standard mobility task, namely the Timed Up and Go test (TUG) with subjects following different instructions while performing a rapid, repetitive goal-directed arm-movement test (arm-movement test). We hypothesized that we would be able to predict gait-related parameters from arm motor behavior, even regardless of age. METHODS Sixty healthy individuals were assigned to three groups (young: mean 26 ± 3 years, middle-aged 48 ± 9, old 68 ± 7). They performed the arm-movement and TUG test under three conditions: preferred (at preferred movement speed), dual-task (while counting backwards), and fast (at fast movement speed). We recorded the number of contacts within 20 s and the TUG duration. We also extracted TUG walking sequences to analyze spatiotemporal gait parameters and evaluated the correlation between arm-movement and TUG results. RESULTS The TUG condition at preferred speed revealed differences in gait speed and step length only between young and old, while dual-task and fast execution increased performance differences significantly among all 3 groups. Our old group's gait speed decreased the most doing the dual-task, while the young group's gait speed increased the most during the fast condition. As in our TUG results, arm-movements were significant faster in young than in middle-aged and old. We observed significant correlations between arm movements and the fast TUG condition, and that the number of contacts closely predicts TUG timefast and gait speedfast. This prediction is more accurate when including age. CONCLUSION We found that the age-related decline in mobility performance that TUG reveals strongly depends on the test instruction: the dual-task and fast condition clearly strengthened group contrasts. Interestingly, a fast TUG performance was predictable by the performance in a fast repetitive goal-directed arm-movements test, even beyond the age effect. We assume that arm movements and the fast TUG condition reflect similarly reduced motor function. TRIAL REGISTRATION German Clinical Trials Register (DRKS) number: DRKS00016999, prospectively registered on March, 26, 2019.
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Affiliation(s)
- Isabelle Daniela Walz
- Department of Neurology and Neuroscience, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany
- Department of Sports and Sport Science, University of Freiburg, Freiburg, Germany
| | - Sarah Waibel
- Department of Neurology and Neuroscience, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Andreas Kuhner
- Department of Computer Science, University of Freiburg, Freiburg, Germany
- Franka Emika GmbH, Freiburg, Germany
| | - Albert Gollhofer
- Department of Sports and Sport Science, University of Freiburg, Freiburg, Germany
| | - Christoph Maurer
- Department of Neurology and Neuroscience, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
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Ingram LA, Butler AA, Lord SR, Gandevia SC. Use of a physiological profile to document upper limb motor impairment in ageing and in neurological conditions. J Physiol 2023; 601:2251-2262. [PMID: 36271625 PMCID: PMC10952577 DOI: 10.1113/jp283703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 10/06/2022] [Indexed: 11/08/2022] Open
Abstract
Profiling performance in the physiological domains underpinning upper limb function (such as strength, sensation, coordination) provides insight into an individual's specific impairments. This compliments the traditional medical 'diagnosis' model that is currently used in contemporary medicine. From an initial battery of 13 tests in which data were collected across the adult lifespan (n = 367, 20-95 years) and in those with neurological conditions (specifically, multiple sclerosis (n = 40), Parkinson's disease (n = 34), and stroke (n = 50)), six tests were selected to comprise a core upper limb physiological profile assessment (PPA). This comprised measures of handgrip strength, simple reaction time, finger dexterity, tactile sensation, bimanual coordination, and a functional task. Individual performance in each of these tests can be compared to a reference population score (devised from our database of healthy individuals aged under 60 years), informing the researcher or clinician how to best direct an intervention or treatment for the individual based on their specific impairment(s). Lastly, a composite score calculated from the average performance across the six tests provides a broad overview of an individual's overall upper limb function. Collectively, the upper limb PPA highlights specific impairments that are prevalent within distinct pathologies and reveals the magnitude of upper limb motor impairment specific to each condition.
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Affiliation(s)
- Lewis A. Ingram
- Neuroscience Research AustraliaSydneyNew South WalesAustralia
- University of South AustraliaAdelaideSouth AustraliaAustralia
| | - Annie A. Butler
- Neuroscience Research AustraliaSydneyNew South WalesAustralia
- University of New South WalesSydneyNew South WalesAustralia
| | - Stephen R. Lord
- Neuroscience Research AustraliaSydneyNew South WalesAustralia
- University of New South WalesSydneyNew South WalesAustralia
| | - Simon C. Gandevia
- Neuroscience Research AustraliaSydneyNew South WalesAustralia
- University of New South WalesSydneyNew South WalesAustralia
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Bayle N, Lempereur M, Hutin E, Motavasseli D, Remy-Neris O, Gracies JM, Cornec G. Comparison of Various Smoothness Metrics for Upper Limb Movements in Middle-Aged Healthy Subjects. SENSORS (BASEL, SWITZERLAND) 2023; 23:1158. [PMID: 36772197 PMCID: PMC9919347 DOI: 10.3390/s23031158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 01/04/2023] [Accepted: 01/17/2023] [Indexed: 06/18/2023]
Abstract
BACKGOUND Metrics for movement smoothness include the number of zero-crossings on the acceleration profile (N0C), the log dimensionless jerk (LDLJ), the normalized averaged rectified jerk (NARJ) and the spectral arc length (SPARC). Sensitivity to the handedness and movement type of these four metrics was compared and correlations with other kinematic parameters were explored in healthy subjects. METHODS Thirty-two healthy participants underwent 3D upper limb motion analysis during two sets of pointing movements on each side. They performed forward- and backward-pointing movements at a self-selected speed to a target located ahead at shoulder height and at 90% arm length, with and without a three-second pause between forward and backward movements. Kinematics were collected, and smoothness metrics were computed. RESULTS LDLJ, NARJ and N0C found backward movements to be smoother, while SPARC found the opposite. Inter- and intra-subject coefficients of variation were lowest for SPARC. LDLJ, NARJ and N0C were correlated with each other and with movement time, unlike SPARC. CONCLUSION There are major differences between smoothness metrics measured in the temporal domain (N0C, LDLJ, NARJ), which depend on movement time, and those measured in the frequency domain, the SPARC, which gave results opposite to the other metrics when comparing backward and forward movements.
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Affiliation(s)
- Nicolas Bayle
- UR 7377 BIOTN, Paris Est Créteil University (UPEC), F-94000 Créteil, France
- AP-HP, Service de Rééducation Neurolocomotrice, Unité de Neurorééducation, Hôpitaux Universitaires Henri Mondor, F-94000 Créteil, France
| | | | - Emilie Hutin
- UR 7377 BIOTN, Paris Est Créteil University (UPEC), F-94000 Créteil, France
- AP-HP, Service de Rééducation Neurolocomotrice, Unité de Neurorééducation, Hôpitaux Universitaires Henri Mondor, F-94000 Créteil, France
| | - Damien Motavasseli
- UR 7377 BIOTN, Paris Est Créteil University (UPEC), F-94000 Créteil, France
- AP-HP, Service de Rééducation Neurolocomotrice, Unité de Neurorééducation, Hôpitaux Universitaires Henri Mondor, F-94000 Créteil, France
| | - Olivier Remy-Neris
- U1101 LaTIM, Brest University, F-29200 Brest, France
- Neurological Physical Medicine and Rehabilitation Department, University Hospital of Brest, F-29200 Brest, France
| | - Jean-Michel Gracies
- UR 7377 BIOTN, Paris Est Créteil University (UPEC), F-94000 Créteil, France
- AP-HP, Service de Rééducation Neurolocomotrice, Unité de Neurorééducation, Hôpitaux Universitaires Henri Mondor, F-94000 Créteil, France
| | - Gwenaël Cornec
- U1101 LaTIM, Brest University, F-29200 Brest, France
- Neurological Physical Medicine and Rehabilitation Department, University Hospital of Brest, F-29200 Brest, France
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Cemim JA, Corrêa PS, Pereira BDS, Souza JSD, Cechetti F. Virtual reality as an intervention tool for upper limbs in Parkinson’s disease: a case series. FISIOTERAPIA E PESQUISA 2022. [DOI: 10.1590/1809-2950/20022329022022en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
ABSTRACT Parkinson’s disease (PD) is a neurodegenerative disorder in which dopaminergic loss occurs in the basal nuclei region. One major complaint associated with PD is upper extremity motor deficits (UE), frequently reported in difficulties to perform activities of daily living (ADL), which may negatively affect quality of life. In recent years new technologies have emerged to assist the UE rehabilitation process in PD, such as virtual reality. Therefore, this study sought to verify the effects of an intervention in the UE with semi-immersive virtual reality equipment on ADLs and quality of life of individuals with PD. Six individuals with PD were selected for intervention, and evaluated by the Mini Mental State Examination, the Hoehn & Yahr Scale, the Unified Parkinson’s Disease Rating Scale (UPDRS), the Parkinson’s Disease Questionnaire (PDQ-39) and the test d’évaluation des membres supérieurs de personnes âgées (TEMPA). The interventions lasted 27 minutes per session, twice per week, for 5 weeks, using the Leap Motion Controller. Individuals showed improvement in muscle strength, muscle endurance, ADLs, and quality of life, all statistically significant. In conclusion, the protocol based on virtual reality applied to the upper limbs effectively improved the activities of daily living and quality of life in individuals with PD.
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Cemim JA, Corrêa PS, Pereira BDS, Souza JSD, Cechetti F. Realidade virtual como ferramenta de intervenção para os membros superiores na doença de Parkinson: série de casos. FISIOTERAPIA E PESQUISA 2022. [DOI: 10.1590/1809-2950/20022329022022pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
RESUMO A doença de Parkinson (DP) é uma desordem neurodegenerativa na qual ocorre a perda dopaminérgica na região dos núcleos da base. Uma das principais queixas associadas à DP são os déficits motores dos membros superiores (MMSS) frequentemente relatados em dificuldades para realizar as atividades de vida diária (AVDs), podendo interferir negativamente na qualidade de vida. Nos últimos anos novas tecnologias surgiram para auxiliar no processo de reabilitação dos MMSS na DP, sendo a realidade virtual uma delas. Portanto, este estudo teve como objetivo verificar os efeitos de uma intervenção nos MMSS com equipamento de realidade virtual semi-imersiva nas AVDs e na qualidade de vida de indivíduos com DP. Foram selecionados seis indivíduos com DP para intervenção, avaliados por meio do miniexame do estado mental, da escala de Hoehn e Yahr, da escala unificada de avaliação para a DP (UPDRS), do questionário sobre a doença de Parkinson (PDQ-39) e do test d’évaluation des membres supérieurs de personnes âgées (Tempa). Seis sujeitos foram submetidos à intervenção com duração de 27 minutos por sessão, duas vezes na semana, por cinco semanas, utilizando o Leap Motion Controller. Obteve-se melhora na força muscular, na resistência muscular, nas AVDs e na qualidade de vida, todos com significância estatística. Dessa forma, verificou-se que o protocolo baseado em realidade virtual aplicada nos MMSS foi eficaz para melhorar as AVDs e a qualidade de vida dos indivíduos com DP deste estudo.
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Statistical Analysis and Kinematic Assessment of Upper Limb Reaching Task in Parkinson's Disease. SENSORS 2022; 22:s22051708. [PMID: 35270853 PMCID: PMC8915106 DOI: 10.3390/s22051708] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 02/04/2022] [Accepted: 02/17/2022] [Indexed: 12/13/2022]
Abstract
The impact of neurodegenerative disorders is twofold; they affect both quality of life and healthcare expenditure. In the case of Parkinson's disease, several strategies have been attempted to support the pharmacological treatment with rehabilitation protocols aimed at restoring motor function. In this scenario, the study of upper limb control mechanisms is particularly relevant due to the complexity of the joints involved in the movement of the arm. For these reasons, it is difficult to define proper indicators of the rehabilitation outcome. In this work, we propose a methodology to analyze and extract an ensemble of kinematic parameters from signals acquired during a complex upper limb reaching task. The methodology is tested in both healthy subjects and Parkinson's disease patients (N = 12), and a statistical analysis is carried out to establish the value of the extracted kinematic features in distinguishing between the two groups under study. The parameters with the greatest number of significances across the submovements are duration, mean velocity, maximum velocity, maximum acceleration, and smoothness. Results allowed the identification of a subset of significant kinematic parameters that could serve as a proof-of-concept for a future definition of potential indicators of the rehabilitation outcome in Parkinson's disease.
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Ingram LA, Carroll VK, Butler AA, Brodie MA, Gandevia SC, Lord SR. Quantifying upper limb motor impairment in people with Parkinson's disease: a physiological profiling approach. PeerJ 2021; 9:e10735. [PMID: 33604177 PMCID: PMC7869669 DOI: 10.7717/peerj.10735] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 12/17/2020] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Upper limb motor impairments, such as slowness of movement and difficulties executing sequential tasks, are common in people with Parkinson's disease (PD). OBJECTIVE To evaluate the validity of the upper limb Physiological Profile Assessment (PPA) as a standard clinical assessment battery in people with PD, by determining whether the tests, which encompass muscle strength, dexterity, arm stability, position sense, skin sensation and bimanual coordination can (a) distinguish people with PD from healthy controls, (b) detect differences in upper limb test domains between "off" and "on" anti-Parkinson medication states and (c) correlate with a validated measure of upper limb function. METHODS Thirty-four participants with PD and 68 healthy controls completed the upper limb PPA tests within a single session. RESULTS People with PD exhibited impaired performance across most test domains. Based on validity, reliability and feasibility, six tests (handgrip strength, finger-press reaction time, 9-hole peg test, bimanual pole test, arm stability, and shirt buttoning) were identified as key tests for the assessment of upper limb function in people with PD. CONCLUSIONS The upper limb PPA provides a valid, quick and simple means of quantifying specific upper limb impairments in people with PD. These findings indicate clinical assessments should prioritise tests of muscle strength, unilateral movement and dexterity, bimanual coordination, arm stability and functional tasks in people with PD as these domains are the most commonly and significantly impaired.
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Affiliation(s)
- Lewis A. Ingram
- Neuroscience Research Australia, Sydney, New South Wales, Australia
- University of New South Wales, Sydney, New South Wales, Australia
| | - Vincent K. Carroll
- NSW Health, Mid North Coast Local Health District, Coffs Harbour, New South Wales, Australia
- Parkinson’s NSW, Sydney, New South Wales, Australia
| | - Annie A. Butler
- Neuroscience Research Australia, Sydney, New South Wales, Australia
- University of New South Wales, Sydney, New South Wales, Australia
| | - Matthew A. Brodie
- Neuroscience Research Australia, Sydney, New South Wales, Australia
- University of New South Wales, Sydney, New South Wales, Australia
| | - Simon C. Gandevia
- Neuroscience Research Australia, Sydney, New South Wales, Australia
- University of New South Wales, Sydney, New South Wales, Australia
| | - Stephen R. Lord
- Neuroscience Research Australia, Sydney, New South Wales, Australia
- University of New South Wales, Sydney, New South Wales, Australia
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Schallert W, Fluet MC, Kesselring J, Kool J. Evaluation of upper limb function with digitizing tablet-based tests: reliability and discriminative validity in healthy persons and patients with neurological disorders. Disabil Rehabil 2020; 44:1465-1473. [PMID: 32757680 DOI: 10.1080/09638288.2020.1800838] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
PURPOSE To evaluate discriminative validity, relative reliability and absolute reliability of four tablet-based tests for the evaluation of upper limb motor function in healthy persons and patients with neurological disorders. METHODS Cross-sectional study in 54 participants: 29 patients with upper limb movement impairment due to a neurological condition recruited from an inpatient rehabilitation centre and 25 healthy persons. Accuracy, speed and path length were analysed for four tablet-based tests: "Spiral drawings," "Tapping," "Follow the dot" and "Trace a star." The area under the receiver operating characteristic curve (AUC) was used to evaluate discriminative validity. Relative reliability was analysed with the intra-class correlation coefficient (ICC), and absolute reliability by limits of agreement (LoA) and minimal detectable difference (MDD). RESULTS All four tests showed excellent discriminative validity for the parameter accuracy (AUC 0.93-0.98). Tapping was the best test for discriminating patients from healthy persons. Test-retest reliability was good for accuracy in all tests (ICC = 0.76-0.88), but poor to moderate for speed and path length (ICC = 0.20-0.69). The MDD varied between 14% and 38%. Performance on the four tablet-based tests was stable between sessions, indicating that there was no learning effect. CONCLUSION The parameter accuracy showed excellent discriminative validity and reliability in all four tablet-based tests. Discriminative validity was excellent for all three parameters in the Tapping test. In the other tasks speed showed good to poor reliability, while the reliability of path-length was poor in all tasks. Results were comparable for the dominant and non-dominant hand. Tablet-based tests have the advantage that patients can use them for self-monitoring of upper limb motor function.Implications for rehabilitationFour tablet-based tests for the assessment of upper limb motor function in patients with upper limb neurological dysfunction were evaluated: "Spiral drawings", "Tapping", "Follow the dot" and "Trace a star". The parameter accuracy in these four tests had excellent discriminative validity and good reliability.Patients can perform the tests independently at home for self-monitoring of progress. This may increase patients' motivation to exercise at home.The results can be sent to physicians, enabling the earlier detection of deterioration, which may require medical attention.
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Affiliation(s)
- Wolfgang Schallert
- Department of Rehabilitation Research, Rehabilitation Centre Valens, Valens, Switzerland.,Department of Physiotherapy, Berner Fachhochschule, Bern, Switzerland
| | - Marie-Christine Fluet
- Swiss Federal Institute of Technology Zurich, Zurich, Switzerland.,ReHaptix GmbH, Rehabilitation Products, Zurich, Switzerland
| | - Juerg Kesselring
- Department of Rehabilitation Research, Rehabilitation Centre Valens, Valens, Switzerland
| | - Jan Kool
- Department of Rehabilitation Research, Rehabilitation Centre Valens, Valens, Switzerland
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12
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Pazzaglia C, Imbimbo I, Tranchita E, Minganti C, Ricciardi D, Monaco RL, Parisi A, Padua L. Reply to Letter to the Editor: 'Comparison of virtual reality rehabilitation and conventional rehabilitation in Parkinson's disease: a randomised controlled trial'. Physiotherapy 2020; 110:88-89. [PMID: 32798048 DOI: 10.1016/j.physio.2020.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Indexed: 11/16/2022]
Affiliation(s)
| | - Isabella Imbimbo
- Department of Neurorehabilitation, IRCCS Don Carlo Gnocchi, Milan, Italy
| | - Eliana Tranchita
- Department of Movement, Human and Health Sciences, Division of Health Sciences, University of Rome Foro Italico, Rome, Italy
| | - Carlo Minganti
- Department of Movement, Human and Health Sciences, Division of Health Sciences, University of Rome Foro Italico, Rome, Italy
| | - Diego Ricciardi
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Rita Lo Monaco
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Attilio Parisi
- Department of Movement, Human and Health Sciences, Division of Health Sciences, University of Rome Foro Italico, Rome, Italy
| | - Luca Padua
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy; Department of Geriatrics, Neurosciences and Orthopaedics, Università Cattolica del Sacro Cuore, Rome, Italy.
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13
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Özden F. Letter to the Editor: "Comparison of virtual reality rehabilitation and conventional rehabilitation in Parkinson's disease: a randomised controlled trial". Physiotherapy 2020; 110:87. [PMID: 32736882 DOI: 10.1016/j.physio.2020.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Fatih Özden
- Muğla Sıtkı Koçman University, Köyceğiz Vocational School of Health Services, Elderly, Care Department, Turkey.
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14
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Fundarò C, Cavalieri C, Pinna GD, Giardini A, Mancini F, Casale R. Upper Limb Interactive Weightless Technology-Aided Intervention and Assessment Picks Out Motor Skills Improvement in Parkinson's Disease: A Pilot Study. Front Neurol 2020; 11:40. [PMID: 32117009 PMCID: PMC7033477 DOI: 10.3389/fneur.2020.00040] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Accepted: 01/13/2020] [Indexed: 11/18/2022] Open
Abstract
Background: In Parkinson's disease, reaching movements are conditioned by motor planning and execution deficiency. Recently, rehabilitation, aided by high technological devices, was employed for Parkinson's disease. Objective: We aimed to (1) investigate the changes in the upper limb motor performances in a sample of a patient with Parkinson's disease after a weightless training, with a passive exoskeleton, in an augmented-feedback environment; (2) highlight differences by motor parameters (performance, speed, and movement accuracy) and by type of movement (simple or complex); and (3) evaluate movement improvements by UPDRS II–III. Methods: Observational pilot study. Twenty right-handed patients with Parkinson's disease, Hohen and Yahr 2, Mini Mental State Examination ≥24 were evaluated. All patients underwent 5 day/week sessions for 4 weeks, 30 min for each arm; the training was performed with 12 exercises (single and multi-joints, horizontal and vertical movements). All the patients were assessed by UPDRS II–III and the evaluation tests provided by the device's software: a simple movement, the vertical capture, and a complex movement, the horizontal capture. For each test, we analyzed reached target percentage, movement execution time, and accuracy. Results: After training, a significant improvement of accuracy and speed for simple movement on the dominant arm, of reached targets and speed for complex movement on both sides were shown. UPDRS II and III improved significantly after training. Conclusions: In our study, a motor training aided by a high technological device improves motor parameters and highlights differences between the type of movement (simple or complex) and movement parameters (speed and accuracy) in a sample of patients with Parkinson's disease.
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Affiliation(s)
- Cira Fundarò
- Neurophysiopathology Unit, Istituti Clinici Scientifici Maugeri, IRCSS, Montescano, Italy
| | - Carlo Cavalieri
- Neuromotory Rehabilitation Unit 1, Istituti Clinici Scientifici Maugeri, IRCSS, Montescano, Italy
| | - Gian Domenico Pinna
- Department of Biomedical Engineering, Istituti Clinici Scientifici Maugeri, IRCSS, Montescano, Italy
| | - Anna Giardini
- Psychology Unit, Istituti Clinici Scientifici Maugeri, IRCSS, Montescano, Italy
| | - Francesca Mancini
- U. O. Neurologia-Stroke Unit e Laboratorio di Neuroscienze, Istituto Auxologico, IRCCS, Milan, Italy
| | - Roberto Casale
- OPUSMedica PC&R, Persons, Care and Research, Piacenza, Italy
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Proud EL, Miller KJ, Bilney B, Morris ME, McGinley JL. Construct validity of the 9-Hole Peg Test and Purdue Pegboard Test in people with mild to moderately severe Parkinson's disease. Physiotherapy 2019; 107:202-208. [PMID: 32026821 DOI: 10.1016/j.physio.2019.12.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Revised: 10/13/2019] [Accepted: 12/09/2019] [Indexed: 10/25/2022]
Abstract
OBJECTIVES To evaluate the construct validity of two dexterity measures, the 9-Hole Peg Test (9HPT) and Purdue Pegboard Test (PPT) in people with Parkinson's disease (PD). DESIGN Cross-sectional observational study. SETTING Testing was conducted at the university or in participants' homes. PARTICIPANTS Thirty community dwelling people with mild to moderately severe PD and no major upper limb comorbidities or cognitive impairments. INTERVENTIONS Pegboard tests were administered in the 'on' and 'end-of-dose' phases of participants' PD medication cycles. Participants rated hand function with two self-report questionnaires - the Manual Ability Measure-36 (MAM-36) and a subset of upper limb items from the MDS-UPDRS. To explore construct validity, we compared 'on' phase pegboard scores with normative values for unimpaired men and women and investigated relationships between pegboard scores and hand function questionnaires. RESULTS In the 'on' phase, pegboard scores were poorer than normative values. Differences in individual subtest scores ranged between 10 and 41%. Correlations between self-reported hand function and pegboard scores were weak to moderately strong in the 'on' phase (r=0.21-0.51), and weak at 'end-of-dose' (r=0.13-0.22). Higher correlation coefficients were observed between hand function and PPT subtest scores than with hand function and 9HPT scores. Most participants reported difficulty with daily hand tasks. CONCLUSIONS We found evidence for construct validity supporting the use of the 9HPT and PPT to evaluate people with mild to moderately severe PD when 'on', but not at the 'end-of-dose'. Results also suggest that the PPT may be more sensitive to PD-related changes in dexterity than the 9HPT.
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Affiliation(s)
- Elizabeth L Proud
- Department of Physiotherapy, School of Health Sciences, The University of Melbourne, Australia.
| | - Kimberly J Miller
- Department of Physiotherapy, School of Health Sciences, The University of Melbourne, Australia; Sunny Hill Health Centre for Children, Vancouver, Canada
| | - Belinda Bilney
- School of Allied Health, Australian Catholic University, Ballarat, Australia
| | - Meg E Morris
- Healthscope and La Trobe Centre for Sport and Exercise Medicine Research, La Trobe University, Australia
| | - Jennifer L McGinley
- Department of Physiotherapy, School of Health Sciences, The University of Melbourne, Australia
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16
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Reliability, validity and responsiveness of the squares test for manual dexterity in people with Parkinson's disease. Clin Neurol Neurosurg 2019; 186:105542. [PMID: 31605895 DOI: 10.1016/j.clineuro.2019.105542] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Revised: 09/26/2019] [Accepted: 09/28/2019] [Indexed: 11/24/2022]
Abstract
OBJECTIVE Impaired manual dexterity is one of the major disorder in people with Parkinson's Disease (PwPD). However, there is limited research examining the measurement properties, especially the validity and responsiveness of the tools used to assess manual dexterity. The aim of this study was to examine reliability, validity, and responsiveness of the Squares Test (ST) in PwPD. PATIENTS AND METHODS Fifty-seven PwPD and 50 healthy people, all of whom were right-handed, were recruited. The ST, Nine-Hole Peg Test, Unified Parkinson's Disease Rating Scale (UPDRS), and Hoehn and Yahr scale were performed in ON state. For responsiveness analysis, the ST and UPDRS motor score (UPDRS-III) were also performed in OFF state. RESULTS The ST showed excellent test-retest reliability. The ST was found to correlate significantly with other outcome measures, which indicated good concurrent validity. PwPD demonstrated significantly lower scores of the ST than healthy people, which demonstrated satisfactory known-groups validity. The ST had excellent discriminant validity. The ST scores of 52 for more affected hand and 62 for less affected hand were shown to best discriminate between PwPD and healthy people. The ST is high internal responsiveness based on standardized effect size and standardized response mean (0.79 and 1.88, respectively for more affected hand and 0.85 and 1.83, respectively for less affected hand), and also PwPD had better performance based on the ST in ON state than in OFF state (p < 0.001 for both hands). Moderate correlations were found between the change scores of the ST and UPDRS-III, which reflected adequate external responsiveness. CONCLUSIONS The ST is a reliable, valid and responsive measurement tool for assessing manual dexterity in PwPD.
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17
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Yang CY, Chen RS, Huang YZ. Analysis and Discrimination of Surface Electromyographic Features for Parkinson's Disease during Elbow Flexion Movements. J Mot Behav 2019; 52:625-633. [PMID: 31538541 DOI: 10.1080/00222895.2019.1666081] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Parkinson's disease (PD) is the second most common neurodegenerative disorder. Early intervention/treatment relies on early diagnosis of PD. There is increasing interest in methods based on electromyography measurements of PD patients because of its noninvasiveness. Thus, this study was to investigate electromyographic (EMG) characteristics of the upper limb between PD patients and healthy control subjects using EMG, and to distinguish PD patients from healthy control subjects according to the EMG information using a support vector machine (SVM) classifier. Sixteen right-handed PD patients and 25 right-handed healthy subjects participated in experiments involving elbow flexion movement. The frequency power, duration, skewness, recurrence rate, and correlation dimension of EMG signals and success rate for the right hand and the skewness of EMG signals for the left hand were found to be significantly different between the two groups. This information was subsequently used to distinguish PD patients from healthy control subjects using the SVM classifier to obtain a mean accuracy of 87.02%. Although the results may not be immediately available to use in clinical applications, the safety, simplicity and speed of the system still merits further consideration. Enhancing performance accuracy and examining PD patients in different stages of disease are anticipated in future investigations.
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Affiliation(s)
- Chia-Yen Yang
- Department of Biomedical Engineering, Ming-Chuan University, Taoyuan, Taiwan
| | - Rou-Shayn Chen
- Division of Movement Disorders, Department of Neurology, Chang Gung Memorial Hospital, Taoyuan, Taiwan1
| | - Ying-Zu Huang
- Neuroscience Research Center and Department of Neurology, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taoyuan, Taiwan.,Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan.,Institute of Cognitive Neuroscience, National Central University, Taoyuan, Taiwan
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18
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Proud EL, Bilney B, Miller KJ, Morris ME, McGinley JL. Measuring Hand Dexterity in People With Parkinson's Disease: Reliability of Pegboard Tests. Am J Occup Ther 2019; 73:7304205050p1-7304205050p8. [PMID: 31318669 DOI: 10.5014/ajot.2019.031112] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
IMPORTANCE Knowledge regarding the reliability of pegboard tests when used to measure dexterity in people with Parkinson's disease (PD) is currently limited. OBJECTIVE To examine the test-retest and interrater reliability of the 9-Hole Peg Test (9HPT) and Purdue Pegboard Test (PPT) in people with PD. DESIGN Cross-sectional observational study. For test-retest reliability, tests were completed on 2 days, 1 wk apart, in the "on" phase and "end-of-dose" period of participants' medication cycle. For interrater reliability, occupational therapists and physical therapists rated prerecorded pegboard test performance of participants with PD. SETTING Test-retest reliability was determined in participants' homes or in a university department. Interrater reliability was determined in a university department or a hospital setting. PARTICIPANTS Test-retest reliability was determined with volunteers diagnosed with PD (N = 30). Interrater reliability was determined with a convenience sample of occupational and physical therapists (N = 11). OUTCOMES AND MEASURES The 9HPT and PPT are commonly used measures of manual dexterity. RESULTS PPT subtests showed higher test-retest reliability (intraclass correlation coefficients [ICCs] ≥ .90) in both phases of the medication cycle compared with the 9HPT (ICCs = .70-.81). Minimal detectable change scores indicated acceptable measurement error for both tools. Interrater reliability for recorded performance of each measure was very good (ICCs > .99), with no calculable measurement error. CONCLUSIONS AND RELEVANCE Although both tools showed adequate test-retest and interrater reliability, results suggest that the PPT may be a more reliable measure of dexterity loss in people with PD. WHAT THIS ARTICLE ADDS This study informs the clinical measurement of the loss of manual dexterity in people with PD, a frequent problem reported by people living with this disorder.
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Affiliation(s)
- Elizabeth L Proud
- Elizabeth L. Proud, PhD, is Online Tutor, Department of Physiotherapy, School of Health Sciences, University of Melbourne, Melbourne, Victoria, Australia;
| | - Belinda Bilney
- Belinda Bilney, PhD, is Associate Professor, School of Allied Health, Australian Catholic University, Ballarat, Victoria, Australia
| | - Kimberly J Miller
- Kimberly J. Miller, PhD, is Senior Fellow, Department of Physiotherapy, School of Health Sciences, University of Melbourne, Melbourne, Victoria, Australia, and Senior Leader, Clinical Education and Special Projects, Sunny Hill Health Centre for Children, Vancouver, British Columbia, Canada
| | - Meg E Morris
- Meg E. Morris, PhD, is Professor, North Eastern Rehabilitation Centre, Healthscope and La Trobe Centre for Sport and Exercise Medicine Research, La Trobe University, Melbourne, Victoria, Australia
| | - Jennifer L McGinley
- Jennifer L. McGinley, PhD, is Associate Professor, Department of Physiotherapy, School of Health Sciences, University of Melbourne, Melbourne, Victoria, Australia
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19
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Cabrera-Martos I, Ortiz-Rubio A, Torres-Sánchez I, López-López L, Rodríguez-Torres J, Carmen Valenza M. Agreement Between Face-to-Face and Tele-assessment of Upper Limb Functioning in Patients with Parkinson Disease. PM R 2019; 11:590-596. [PMID: 30840363 DOI: 10.1002/pmrj.12001] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Accepted: 10/13/2018] [Indexed: 11/09/2022]
Abstract
BACKGROUND Upper limb disturbances are prevalent in patients with Parkinson disease (PD) and can limit their participation in activities of daily living. Tele-assessment of upper limb motor symptoms using an Internet application may be an alternative for addressing the growing demand for monitoring of disease progression. OBJECTIVE To evaluate the level of agreement between face-to-face and tele-assessment of patients with PD. DESIGN Reliability study. SETTING Parkinson's Disease Association. PARTICIPANTS Twenty-one patients with PD from a local association participated in the study. METHODS Patients attended a session for clinical face-to-face and real-time online tele-assessment. MAIN OUTCOME MEASUREMENTS Upper limb measures of function (assessed with the Manual Ability Measure 16), dexterity (evaluated using the coin rotation task), motor speed (assessed by the finger tapping test), tremor (evaluated with the Fahn-Tolosa-Marin Tremor Rating Scale), and range of motion (using the Kinovea software) were recorded by two independent researchers. RESULTS All the outcome measures evaluated showed a good interrater, intraclass correlation coefficient (ρ > 0.75). In addition, most confidence intervals were narrow and excluded 0.8. The lowest reliability was obtained for elbow flexion of the most affected upper limb (ρ = 0.75; confidence interval 0.49-0.89) and the highest reliability for finger tapping tests (ρ = 1; 1, 1). CONCLUSIONS This study demonstrates high interrater reliability of upper limb tele-assessment in patients with PD compared to a face-to-face assessment. LEVEL OF EVIDENCE III.
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Affiliation(s)
- Irene Cabrera-Martos
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, 60 Ilustración Av., 18016 Granada, Spain
| | - Araceli Ortiz-Rubio
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Granada, Spain
| | - Irene Torres-Sánchez
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Granada, Spain
| | - Laura López-López
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Granada, Spain
| | - Janet Rodríguez-Torres
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Granada, Spain
| | - M Carmen Valenza
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Granada, Spain
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Corona F, Pilloni G, Arippa F, Porta M, Casula C, Cossu G, Pau M. Quantitative assessment of upper limb functional impairments in people with Parkinson's disease. Clin Biomech (Bristol, Avon) 2018; 57:137-143. [PMID: 29986276 DOI: 10.1016/j.clinbiomech.2018.06.019] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Revised: 06/26/2018] [Accepted: 06/26/2018] [Indexed: 02/07/2023]
Abstract
BACKGROUND In clinical routine, upper limb motor disorders of people with Parkinson's disease are commonly assessed using scale- or timed tests, but such tools are not fully suitable for providing detailed information about their type and magnitude. To partly overcome these limitations, the present study aims to quantitatively investigate upper limb functional impairments through quantitative analysis of the "hand-to-mouth" task. METHODS Twenty-five individuals with Parkinson's disease and 20 age-matched healthy individuals underwent a kinematic analysis of the hand-to-mouth task from which spatio-temporal and kinematic measures, including summary measures (Arm Variable Score and Arm Profile Score), were calculated and correlated with clinical scores (Hoehn & Yahr, H&Y and the Unified Parkinson Disease Rating Scale, UPDRS). FINDINGS The "hand-to-mouth" movement is significantly altered in individuals with Parkinson's disease, especially in terms of reduced velocity, reduced range of motion of elbow flexion-extension and deviation from a physiologic pattern (Arm Profile Score 12.8° vs. 10.1° of unaffected, P = 0.002). Significant moderate correlations were found between movement duration and UPDRS-III (rho = 0.478, P = 0.001) and between the Arm Profile Score and H&Y (rho = 0.481, P = 0.024) and UPDRS-III (rho = 0.326, P = 0.001). INTERPRETATION On the basis of such findings, we can state that the kinematic analysis of "hand-to-mouth" movement, and in particular the summary indexes, are suitable for easily representing upper limb movement alterations in people with Parkinson's disease, thus allowing the monitoring either of disease progression or effectiveness of pharmacologic and rehabilitative treatments.
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Affiliation(s)
- Federica Corona
- Department of Mechanical, Chemical and Materials Engineering, University of Cagliari, Cagliari, Italy.
| | - Giuseppina Pilloni
- Department of Mechanical, Chemical and Materials Engineering, University of Cagliari, Cagliari, Italy
| | - Federico Arippa
- Department of Mechanical, Chemical and Materials Engineering, University of Cagliari, Cagliari, Italy
| | - Micaela Porta
- Department of Mechanical, Chemical and Materials Engineering, University of Cagliari, Cagliari, Italy
| | - Carlo Casula
- AOB "G. Brotzu" General Hospital, Cagliari, Italy
| | | | - Massimiliano Pau
- Department of Mechanical, Chemical and Materials Engineering, University of Cagliari, Cagliari, Italy
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Miyahara Y, Jitkritsadakul O, Sringean J, Aungkab N, Khongprasert S, Bhidayasiri R. Can therapeutic Thai massage improve upper limb muscle strength in Parkinson's disease? An objective randomized-controlled trial. J Tradit Complement Med 2018; 8:261-266. [PMID: 29736380 PMCID: PMC5934701 DOI: 10.1016/j.jtcme.2018.01.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Revised: 01/04/2018] [Accepted: 01/05/2018] [Indexed: 01/19/2023] Open
Abstract
Muscle weakness is a frequent complaint amongst Parkinson's disease (PD) patients. However, evidence-based therapeutic options for this symptom are limited. We objectively measure the efficacy of therapeutic Thai massage (TTM) on upper limb muscle strength, using an isokinetic dynamometer. A total of 60 PD patients with muscle weakness that is not related to their ‘off’ periods or other neurological causes were equally randomized to TTM intervention (n = 30), consisting of six TTM sessions over a 3-week period, or standard medical care (no intervention, n = 30). Primary outcomes included peak extension and flexion torques. Scale-based outcomes, including Unified Parkinson's Disease Rating Scale (UPDRS) and visual analogue scale for pain (VAS) were also performed. From baseline to end of treatment, patients in the intervention group showed significant improvement on primary objective outcomes, including peak flexion torque (F = 30.613, p < .001) and peak extension torque (F = 35.569, p < .001) and time to maximal flexion speed (F = 14.216, p = .001). Scale-based assessments mirrored improvements in the objective outcomes with a significant improvement from baseline to end of treatment of the UPDRS-bradykinesia of a more affected upper limb (F = 9.239, p = .005), and VAS (F = 69.864, p < .001) following the TTM intervention, compared to the control group. No patients reported adverse events in association with TTM. Our findings provide objective evidence that TTM used in combination with standard medical therapies is effective in improving upper limb muscle strength in patients with PD. Further studies are needed to determine the efficacy of TTM on other motor and non-motor symptoms in PD.
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Affiliation(s)
- Yuka Miyahara
- Chulalongkorn Center of Excellence for Parkinson's Disease & Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, 10330, Thailand.,College of Public Health Sciences, Chulalongkorn University, Bangkok, 10330, Thailand.,Wat Pho Thai Traditional Medical School, Bangkok, 10200, Thailand
| | - Onanong Jitkritsadakul
- Chulalongkorn Center of Excellence for Parkinson's Disease & Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, 10330, Thailand
| | - Jirada Sringean
- Chulalongkorn Center of Excellence for Parkinson's Disease & Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, 10330, Thailand
| | - Nicharee Aungkab
- Chulalongkorn Center of Excellence for Parkinson's Disease & Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, 10330, Thailand
| | - Surasa Khongprasert
- Faculty of Sports Science, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Roongroj Bhidayasiri
- Chulalongkorn Center of Excellence for Parkinson's Disease & Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, 10330, Thailand.,Department of Neurology, Juntendo University, Tokyo, Japan
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22
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Nackaerts E, Heremans E, Smits-Engelsman BCM, Broeder S, Vandenberghe W, Bergmans B, Nieuwboer A. Validity and reliability of a new tool to evaluate handwriting difficulties in Parkinson's disease. PLoS One 2017; 12:e0173157. [PMID: 28253374 PMCID: PMC5333892 DOI: 10.1371/journal.pone.0173157] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2016] [Accepted: 02/15/2017] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Handwriting in Parkinson's disease (PD) features specific abnormalities which are difficult to assess in clinical practice since no specific tool for evaluation of spontaneous movement is currently available. OBJECTIVE This study aims to validate the 'Systematic Screening of Handwriting Difficulties' (SOS-test) in patients with PD. METHODS Handwriting performance of 87 patients and 26 healthy age-matched controls was examined using the SOS-test. Sixty-seven patients were tested a second time within a period of one month. Participants were asked to copy as much as possible of a text within 5 minutes with the instruction to write as neatly and quickly as in daily life. Writing speed (letters in 5 minutes), size (mm) and quality of handwriting were compared. Correlation analysis was performed between SOS outcomes and other fine motor skill measurements and disease characteristics. Intrarater, interrater and test-retest reliability were assessed using the intraclass correlation coefficient (ICC) and Spearman correlation coefficient. RESULTS Patients with PD had a smaller (p = 0.043) and slower (p<0.001) handwriting and showed worse writing quality (p = 0.031) compared to controls. The outcomes of the SOS-test significantly correlated with fine motor skill performance and disease duration and severity. Furthermore, the test showed excellent intrarater, interrater and test-retest reliability (ICC > 0.769 for both groups). CONCLUSION The SOS-test is a short and effective tool to detect handwriting problems in PD with excellent reliability. It can therefore be recommended as a clinical instrument for standardized screening of handwriting deficits in PD.
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Affiliation(s)
| | - Elke Heremans
- Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
| | | | - Sanne Broeder
- Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
| | - Wim Vandenberghe
- Department of Neurosciences, KU Leuven, Leuven, Belgium
- Department of Neurology, University Hospitals Leuven, Leuven, Belgium
| | - Bruno Bergmans
- Department of Neurology, A.Z. Sint-Jan Brugge-Oostende, Bruges, Belgium
| | - Alice Nieuwboer
- Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
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de Freitas PR, Lemos AE, Santos MP, Michaelsen SM, Corrêa CL, Swarowsky A. "Test D'évaluation Des Membres Supérieurs Des Personnes Âgées" (TEMPA) to assess upper limb activity in Parkinson's disease. J Hand Ther 2016; 30:320-327. [PMID: 27899223 DOI: 10.1016/j.jht.2016.07.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Revised: 05/16/2016] [Accepted: 07/12/2016] [Indexed: 02/03/2023]
Abstract
STUDY DESIGN Cross-sectional and observational study. PURPOSE OF THE STUDY Assess upper limb (UL) activity limitations using the "Test d'Evaluation des Membres Supérieurs Des Personnes Agées" (TEMPA) in individuals with Parkinson's disease (PD) and verify its clinimetrics properties. METHODS The following were evaluated: internal consistency, interrater and test-retest reliability; concurrent validity; convergent validity; know group's validity; minimal detectable change, floor and ceiling effects, and the relationship between UL activity limitations and the presence of freezing of gait. RESULTS Excellent reliability and interrater agreement (intraclass correlation coefficient = 0.99 and κ = 0.92) and test-retest reliability (intraclass correlation coefficient = 0.97) were found, as well internal consistency (α = 0.99). A moderate negative correlation was found between TEMPA and section II of the Unified Parkinson's Disease Rating Scale (ρ = -0.58; P = .001), and moderate/low between the test and the Nine Hole Peg Test values of the right UL and moderate for left UL (ρ = 0.56 and ρ = 0.41; P = .001) (ρ = 0.52 and ρ = 0.51; P = .001 and P = .002), respectively. No significant relationship was found with freezing episodes (P = .057). DISCUSSION TEMPA is useful for assessing UL activity limitations in PD, have adequate clinimetrics properties and is capable of detecting the influence of motor symptoms during the carrying out of daily living tasks. No differences were found between freezers and no freezers. LEVEL OF EVIDENCE N/A.
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Affiliation(s)
- Paula Ruiz de Freitas
- Physical Therapy Department, Experimental Research Laboratory (LAPEX), University of the State of Santa Catarina (UDESC), Florianópolis, Brazil; Physical Therapy Department, Physical Therapy Postgraduate Program, University of the State of Santa Catarina (UDESC), Florianópolis, Brazil
| | - Ana Elisa Lemos
- Physical Therapy Department, Physical Education Postgraduate Program, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Mariana Palla Santos
- Physical Therapy Department, Experimental Research Laboratory (LAPEX), University of the State of Santa Catarina (UDESC), Florianópolis, Brazil; Physical Therapy Department, Physical Therapy Postgraduate Program, University of the State of Santa Catarina (UDESC), Florianópolis, Brazil
| | - Stella Maris Michaelsen
- Physical Therapy Department, Physical Therapy Postgraduate Program, University of the State of Santa Catarina (UDESC), Florianópolis, Brazil
| | - Clynton Lourenço Corrêa
- Physical Therapy Department, Physical Education Postgraduate Program, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Alessandra Swarowsky
- Physical Therapy Department, Experimental Research Laboratory (LAPEX), University of the State of Santa Catarina (UDESC), Florianópolis, Brazil; Physical Therapy Department, Physical Therapy Postgraduate Program, University of the State of Santa Catarina (UDESC), Florianópolis, Brazil.
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24
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Asakawa T, Fang H, Sugiyama K, Nozaki T, Kobayashi S, Hong Z, Suzuki K, Mori N, Yang Y, Hua F, Ding G, Wen G, Namba H, Xia Y. Human behavioral assessments in current research of Parkinson's disease. Neurosci Biobehav Rev 2016; 68:741-772. [PMID: 27375277 DOI: 10.1016/j.neubiorev.2016.06.036] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Revised: 06/23/2016] [Accepted: 06/24/2016] [Indexed: 12/22/2022]
Abstract
Parkinson's disease (PD) is traditionally classified as a movement disorder because patients mainly complain about motor symptoms. Recently, non-motor symptoms of PD have been recognized by clinicians and scientists as early signs of PD, and they are detrimental factors in the quality of life in advanced PD patients. It is crucial to comprehensively understand the essence of behavioral assessments, from the simplest measurement of certain symptoms to complex neuropsychological tasks. We have recently reviewed behavioral assessments in PD research with animal models (Asakawa et al., 2016). As a companion volume, this article will systematically review the behavioral assessments of motor and non-motor PD symptoms of human patients in current research. The major aims of this article are: (1) promoting a comparative understanding of various behavioral assessments in terms of the principle and measuring indexes; (2) addressing the major strengths and weaknesses of these behavioral assessments for a better selection of tasks/tests in order to avoid biased conclusions due to inappropriate assessments; and (3) presenting new concepts regarding the development of wearable devices and mobile internet in future assessments. In conclusion we emphasize the importance of improving the assessments for non-motor symptoms because of their complex and unique mechanisms in human PD brains.
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Affiliation(s)
- Tetsuya Asakawa
- Department of Neurosurgery, Hamamatsu University School of Medicine, Handayama, Hamamatsu-city, Shizuoka, Japan; Department of Psychiatry, Hamamatsu University School of Medicine, Handayama, Hamamatsu-city, Shizuoka, Japan.
| | - Huan Fang
- Department of Pharmacy, Jinshan Hospital of Fudan University, Shanghai, China
| | - Kenji Sugiyama
- Department of Neurosurgery, Hamamatsu University School of Medicine, Handayama, Hamamatsu-city, Shizuoka, Japan
| | - Takao Nozaki
- Department of Neurosurgery, Hamamatsu University School of Medicine, Handayama, Hamamatsu-city, Shizuoka, Japan
| | - Susumu Kobayashi
- Department of Neurosurgery, Hamamatsu University School of Medicine, Handayama, Hamamatsu-city, Shizuoka, Japan
| | - Zhen Hong
- Department of Neurology, Huashan Hospital of Fudan University, Shanghai, China
| | - Katsuaki Suzuki
- Department of Psychiatry, Hamamatsu University School of Medicine, Handayama, Hamamatsu-city, Shizuoka, Japan
| | - Norio Mori
- Department of Psychiatry, Hamamatsu University School of Medicine, Handayama, Hamamatsu-city, Shizuoka, Japan
| | - Yilin Yang
- The First People's Hospital of Changzhou, Soochow University School of Medicine, Changzhou, China
| | - Fei Hua
- The First People's Hospital of Changzhou, Soochow University School of Medicine, Changzhou, China
| | - Guanghong Ding
- Shanghai Key laboratory of Acupuncture Mechanism and Acupoint Function, Fudan University, Shanghai, China
| | - Guoqiang Wen
- Department of Neurology, Hainan General Hospital, Haikou, Hainan, China
| | - Hiroki Namba
- Department of Neurosurgery, Hamamatsu University School of Medicine, Handayama, Hamamatsu-city, Shizuoka, Japan
| | - Ying Xia
- Department of Neurosurgery, The University of Texas McGovern Medical School, Houston, TX 77030, USA.
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Heremans E, Nackaerts E, Broeder S, Vervoort G, Swinnen SP, Nieuwboer A. Handwriting Impairments in People With Parkinson's Disease and Freezing of Gait. Neurorehabil Neural Repair 2016; 30:911-919. [PMID: 27094858 DOI: 10.1177/1545968316642743] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Recent studies show that patients with Parkinson's disease (PD) and freezing of gait (FOG) experience motor problems outside their gait freezing episodes. Because handwriting is also a sequential movement, it may be affected in PD patients with FOG relative to those without. OBJECTIVE The current study aimed to assess the quality of writing in PD patients with and without FOG in comparison to healthy controls (CTs) during various writing tasks. METHODS Handwriting was assessed by the writing of cursive loops on a touch-sensitive writing tablet and by means of the Systematic Screening of Handwriting Difficulties (SOS) test in 30 PD patients with and without freezing and 15 healthy age-matched CTs. The tablet tests were performed at 2 different sizes, either continuously or alternatingly, as indicated by visual target lines. RESULTS Patients with freezing showed decreased writing amplitudes and increased variability compared with CTs and patients without freezing on the writing tablet tests. Writing problems were present during both tests but were more pronounced during writing at alternating compared with writing at continuous size. Patients with freezing also had a higher total score on the SOS test than patients without freezing and CTs, reflecting more extensive handwriting problems, particularly with writing fluency. CONCLUSIONS Writing is more severely affected in PD patients with FOG than in those without FOG. These results indicate that deficient movement sequencing and adaptation is a generic problem in patients with FOG.
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