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Mack M, Badache A, Erden A, Giannaki CD, Haider S, Kaltsatou A, Kömürcü Akik B, Netz Y, Pavlova I, Stavrinou PS, Voelcker-Rehage C, Audiffren M. Chronic exercise effects on overall depression severity and distinct depressive symptoms in older adults: A protocol of a systematic and meta-analytic review. PLoS One 2024; 19:e0297348. [PMID: 38781250 PMCID: PMC11115242 DOI: 10.1371/journal.pone.0297348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 12/21/2023] [Indexed: 05/25/2024] Open
Abstract
INTRODUCTION There is high evidence that chronic exercise benefits overall depression severity in older adults. However, late-life depression is characterized by considerable heterogeneity in clinical manifestation emphasizing the need for more individualized exercise intervention programs. Therefore, the objective of the proposed review is to investigate the effects of chronic exercise on overall depression severity and on different symptoms of depression in randomized controlled trials (RCTs) including older adults with a mean age of at least 60 years, and by considering the moderating effects of intervention characteristics and individual characteristics. METHODS This protocol is guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols (PRISMA-P). We will use the Population-Intervention-Comparator-Outcomes-Study design (PICOS) criteria for study inclusion and will search the following database sources for relevant RCTs: Web of Science, Academic Search Complete, CINAHL, APA Psycinfo, SPORTDiscuss, Cochrane. Two independent reviewers will conduct the study selection, data extraction, and quality assessment. Disagreement will be solved by a third reviewer. Primary outcome will be changes in overall depression severity and secondary outcomes will encompass changes in symptoms of depression as defined by the DSM-5, such as sleep quality, fatigue, anxiety, mood, apathy, changes in weight, information processing speed, and executive functions, from baseline until the end of the intervention and to any available intermediary measurement or follow up. Meta-analysis will be undertaken to synthesize the effects of chronic exercise on primary and secondary outcomes. Subgroup analysis will investigate the moderating effects of intervention characteristics (frequency, intensity, duration, type of exercise, cognitive demand, social interactions, exercise supervision, behavioral change techniques, compliance, study design, dropout-rate, type of control group) and individual characteristics (age, sex, education, functional capacity, global cognition, population) on primary and secondary outcomes. Additionally, we plan to assess quality of evidence and publication bias, and to carry out sensitivity analysis. CONCLUSION The results of the proposed review are anticipated to have a substantial impact on research and clinical practice. On the one hand, the review's conclusions could form the foundation for developing evidence-based recommendations for individualized exercise programs that alleviate depression in older adults. On the other hand, by revealing research gaps, the review results could encourage the formulation of research questions for further RCTs. PROTOCOL REGISTRATION NUMBER This protocol has been published in the Prospero repository (PROSPERO 2022 CRD42022361418, available from: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022361418).
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Affiliation(s)
- Melanie Mack
- Centre for the Interdisciplinary Study of Gerontology and Vulnerability, University of Geneva, Geneva, Switzerland
- Department of Neuromotor Behavior and Exercise, Institute of Sport and Exercise Sciences, University of Münster, Münster, Germany
| | - Andreea Badache
- Department of Disability Research, National Research School on Ageing and Health, Örebro University, Örebro, Sweden
| | - Arzu Erden
- Department of Physiotherapy and Rehabilitation, Faculty of Health Science, Karadeniz Technical University, Trabzon, Turkey
| | | | - Sandra Haider
- Center for Public Health, Department of Social and Preventive Medicine, Medical University of Vienna, Vienna, Austria
| | - Antonia Kaltsatou
- Functional Architecture of Mammals in their Environment (FAME) Laboratory, Department of Physical Education and Sport Science, University of Thessaly, Volos, Greece
| | - Burcu Kömürcü Akik
- Department of Psychology, Faculty of Languages and History-Geography, Ankara University, Ankara, Turkey
| | - Yaël Netz
- The Levinsky-Wingate Academic Center, Tel Aviv, Israel
- Department of Health Promotion and Rehabilitation, Lithuanian Sports University, Kaunas, Lithuania
| | - Iuliia Pavlova
- Department of Theory and Methods of Physical Culture, Lviv State University of Physical Culture, Lviv, Ukraine
| | | | - Claudia Voelcker-Rehage
- Department of Neuromotor Behavior and Exercise, Institute of Sport and Exercise Sciences, University of Münster, Münster, Germany
| | - Michel Audiffren
- Cognition and Learning Research Center, Maison des Sciences de l’Homme et de la Société, CNRS, University of Poitiers, Poitiers, France
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Bennett HB, Walter CS, Oholendt CK, Coleman KS, Vincenzo JL. Views of in-person and virtual group exercise before and during the pandemic in people with Parkinson disease. PM R 2023; 15:772-779. [PMID: 35596118 PMCID: PMC10119971 DOI: 10.1002/pmrj.12848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 04/11/2022] [Accepted: 04/19/2022] [Indexed: 11/06/2022]
Abstract
INTRODUCTION Due to coronavirus disease 2019 (COVID-19), many health/wellness programs transitioned from in-person to virtual. This mixed-methods study aims to explore the perceptions of older adults with Parkinson disease (PD) regarding in-person versus virtual-based Parkinson-specific exercise classes (PDEx). OBJECTIVE Explore experiences, perceptions, and perceived effect of participating in and transitioning from in-person to virtual PDEx in people with Parkinson disease (PwPD). DESIGN Cross-sectional mixed-methods design using an online survey and focus groups. SETTING PwPD who participated in an in-person and virtual PDEx (n = 26) were recruited to participate and completed online surveys and focus groups from their home during the COVID-19 pandemic. PARTICIPANTS PwPD who participated in an in-person and virtual PDEx and agreed to participate completed an online survey (n = 16; male = 8; mean age = 74 years) and focus groups (n = 9; male = 4; mean age = 75 years). INTERVENTIONS N/A MAIN OUTCOME MEASURES: Participants completed survey questions and participated in focus groups regarding their perceptions, attitudes, and perceived changes in PD-related symptoms since participating in the PDEx, as well as barriers and facilitators to participating in virtual PDEx. RESULTS Participants felt PDEx was somewhat to very safe and beneficial. In the computer, comfort, and perceptions survey, participants reported perceived improved mobility (63%), balance (75%), and overall health (63%) since participating the PDEx, whereas some participants reported improved mental health (38%). Participants reported minimal difficulty with accessing virtual PDEx. Most participants stated that they would prefer to participate in a combination of in-person and virtual programming. Focus-group participants emphasized that virtual PDEx provided social and emotional support and improved confidence to perform and maintain an exercise regimen. CONCLUSION PwPD who transitioned from an in-person to a virtual PDEx felt the program was safe, effective, and improved or prevented declines in their mobility and balance. PwPD who transitioned to a virtual PDEx also reported benefits in non-motor symptoms such as social isolation.
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Affiliation(s)
- Holly B. Bennett
- University of Arkansas for Medical Sciences, Department of Physical Therapy, Fayetteville, Arkansas, USA
| | - Christopher S. Walter
- University of Arkansas for Medical Sciences, Department of Physical Therapy, Fayetteville, Arkansas, USA
| | - Chris K. Oholendt
- Reynolds Institute on Aging Ottenheimer Fitness Center, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Kellie S. Coleman
- Reynolds Institute on Aging Ottenheimer Fitness Center, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Jennifer L. Vincenzo
- University of Arkansas for Medical Sciences, Department of Physical Therapy, Fayetteville, Arkansas, USA
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Deng P, Xu K, Zhou X, Xiang Y, Xu Q, Sun Q, Li Y, Yu H, Wu X, Yan X, Guo J, Tang B, Liu Z. Constructing prediction models for excessive daytime sleepiness by nomogram and machine learning: A large Chinese multicenter cohort study. Front Aging Neurosci 2022; 14:938071. [PMID: 35966776 PMCID: PMC9372350 DOI: 10.3389/fnagi.2022.938071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 07/12/2022] [Indexed: 11/13/2022] Open
Abstract
ObjectiveAlthough risk factors for excessive daytime sleepiness (EDS) have been reported, there are still few cohort-based predictive models for EDS in Parkinson’s disease (PD). This 1-year longitudinal study aimed to develop a predictive model of EDS in patients with PD using a nomogram and machine learning (ML).Materials and methodsA total of 995 patients with PD without EDS were included, and clinical data during the baseline period were recorded, which included basic information as well as motor and non-motor symptoms. One year later, the presence of EDS in this population was re-evaluated. First, the baseline characteristics of patients with PD with or without EDS were analyzed. Furthermore, a Cox proportional risk regression model and XGBoost ML were used to construct a prediction model of EDS in PD.ResultsAt the 1-year follow-up, EDS occurred in 260 of 995 patients with PD (26.13%). Baseline features analysis showed that EDS correlated significantly with age, age of onset (AOO), hypertension, freezing of gait (FOG). In the Cox proportional risk regression model, we included high body mass index (BMI), late AOO, low motor score on the 39-item Parkinson’s Disease Questionnaire (PDQ-39), low orientation score on the Mini-Mental State Examination (MMSE), and absence of FOG. Kaplan–Meier survival curves showed that the survival prognosis of patients with PD in the high-risk group was significantly worse than that in the low-risk group. XGBoost demonstrated that BMI, AOO, PDQ-39 motor score, MMSE orientation score, and FOG contributed to the model to different degrees, in decreasing order of importance, and the overall accuracy of the model was 71.86% after testing.ConclusionIn this study, we showed that risk factors for EDS in patients with PD include high BMI, late AOO, a low motor score of PDQ-39, low orientation score of MMSE, and lack of FOG, and their importance decreased in turn. Our model can predict EDS in PD with relative effectivity and accuracy.
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Affiliation(s)
- Penghui Deng
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Kun Xu
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Xiaoxia Zhou
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Yaqin Xiang
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Qian Xu
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Qiying Sun
- Department of Geriatrics, Xiangya Hospital, Central South University, Changsha, China
| | - Yan Li
- Research Institute, Hunan Kechuang Information Technology Joint-Stock Co., Ltd., Changsha, China
| | - Haiqing Yu
- Research Institute, Hunan Kechuang Information Technology Joint-Stock Co., Ltd., Changsha, China
| | - Xinyin Wu
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
| | - Xinxiang Yan
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Jifeng Guo
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
- Key Laboratory of Hunan Province in Neurodegenerative Disorders, Central South University, Changsha, China
- Hunan Key Laboratory of Medical Genetics, Center for Medical Genetics, School of Life Sciences, Central South University, Changsha, China
| | - Beisha Tang
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
- Key Laboratory of Hunan Province in Neurodegenerative Disorders, Central South University, Changsha, China
- Hunan Key Laboratory of Medical Genetics, Center for Medical Genetics, School of Life Sciences, Central South University, Changsha, China
| | - Zhenhua Liu
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
- Key Laboratory of Hunan Province in Neurodegenerative Disorders, Central South University, Changsha, China
- Hunan Key Laboratory of Medical Genetics, Center for Medical Genetics, School of Life Sciences, Central South University, Changsha, China
- *Correspondence: Zhenhua Liu,
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Frisaldi E, Bottino P, Fabbri M, Trucco M, De Ceglia A, Esposito N, Barbiani D, Camerone EM, Costa F, Destefanis C, Milano E, Massazza G, Zibetti M, Lopiano L, Benedetti F. Effectiveness of a dance-physiotherapy combined intervention in Parkinson's disease: a randomized controlled pilot trial. Neurol Sci 2021; 42:5045-5053. [PMID: 33743108 DOI: 10.1007/s10072-021-05171-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 03/06/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Physical therapies have been recommended as crucial components in Parkinson's disease (PD) rehabilitation. OBJECTIVE The study aims to examine the effectiveness of a new dance-physiotherapy combined intervention, called DArT method, in mild PD patients. METHODS A prospective, randomized, single-blind, controlled pilot trial was conducted on 38 mild PD patients under dopaminergic therapy. The intervention consisted in an add-on protocol: the control group received 1 h of conventional physiotherapy followed by 1 h of conventional physiotherapy each day, 3 times a week, for 5 weeks. The experimental group received 1 h of conventional physiotherapy followed by 1 h of dance class each day, 3 times a week, for 5 weeks. The week before and after the training period, patients were assessed for motor, cognitive, emotional, and sensory components of PD, with MDS-UPDRS-III as primary outcome measure. RESULTS DArT method was associated with a 2.72-point reduction in the post-treatment MDS-UPDRS-III total score compared to control group (95% CI - 5.28, - 0.16, p = 0.038, d = 0.71), and with a 2.16-point reduction in the post-treatment MDS-UPDRS-III upper body subscore (95% CI - 3.56, - 0.76, p = 0.003, d = 1.02). Conversely, conventional physiotherapy program was associated with a 2.95-point reduction in the post-treatment trait anxiety compared to the experimental group (95% CI 0.19, 5.71, p = 0.037, d = 0.70). Withdrawal and fall rates were equal to 0% in both groups. CONCLUSION DArT method showed to be safe, well accepted, and more effective than an intensive program of conventional physiotherapy in improving motor impairment in mild PD.
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Affiliation(s)
- Elisa Frisaldi
- Rita Levi-Montalcini Department of Neuroscience, University of Turin Medical School, corso Raffaello 30, 10125, Turin, Italy.
| | - Piero Bottino
- Division of Physical and Rehabilitation Medicine, Presidio Sanitario San Camillo, Turin, Italy
| | - Margherita Fabbri
- Rita Levi-Montalcini Department of Neuroscience and Regional Reference Center of Movement Disorders, University of Turin Medical School, Turin, Italy.,Department of Neurosciences, Clinical Investigation Center CIC 1436, Parkinson Toulouse Expert Centre, NS-Park/FCRIN Network and Neuro Toul COEN Centre; Toulouse University Hospital; INSERM; University of Toulouse 3, Toulouse, France
| | - Marco Trucco
- Division of Physical and Rehabilitation Medicine, Presidio Sanitario San Camillo, Turin, Italy
| | - Alessandra De Ceglia
- Division of Physical and Rehabilitation Medicine, Presidio Sanitario San Camillo, Turin, Italy
| | - Nadia Esposito
- Division of Physical and Rehabilitation Medicine, Presidio Sanitario San Camillo, Turin, Italy
| | - Diletta Barbiani
- Rita Levi-Montalcini Department of Neuroscience, University of Turin Medical School, corso Raffaello 30, 10125, Turin, Italy
| | - Eleonora Maria Camerone
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Campus of Savona, Savona, Italy
| | - Federico Costa
- Division of Physical and Rehabilitation Medicine, Department of Surgical Sciences, University of Turin, Turin, Italy
| | - Cristina Destefanis
- Division of Physical and Rehabilitation Medicine, Presidio Sanitario San Camillo, Turin, Italy
| | - Edoardo Milano
- Division of Physical and Rehabilitation Medicine, Presidio Sanitario San Camillo, Turin, Italy
| | - Giuseppe Massazza
- Division of Physical and Rehabilitation Medicine, Department of Surgical Sciences, University of Turin, Turin, Italy
| | - Maurizio Zibetti
- Rita Levi-Montalcini Department of Neuroscience and Regional Reference Center of Movement Disorders, University of Turin Medical School, Turin, Italy
| | - Leonardo Lopiano
- Rita Levi-Montalcini Department of Neuroscience and Regional Reference Center of Movement Disorders, University of Turin Medical School, Turin, Italy
| | - Fabrizio Benedetti
- Rita Levi-Montalcini Department of Neuroscience, University of Turin Medical School, corso Raffaello 30, 10125, Turin, Italy.,Medicine and Physiology of Hypoxia, Plateau Rosà, Switzerland
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What Determines Spontaneous Physical Activity in Patients with Parkinson's Disease? J Clin Med 2020; 9:jcm9051296. [PMID: 32369962 PMCID: PMC7288325 DOI: 10.3390/jcm9051296] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 04/27/2020] [Accepted: 04/28/2020] [Indexed: 11/17/2022] Open
Abstract
Physical activity (PA) is a factor that may have an influence on the symptoms of Parkinson's disease (PD). The aim of this study was to identify the potential determinants of spontaneous PA in a PD patient group. A total of 134 PD patients aged 65.2 ± 9.2 years with a Hoehn-Yahr scale score ≤4 and a Mini Mental State Examination (MMSE) score ≥24 were examined. For the study's purposes, the authors analyzed age, sex, education, history of PD, dopaminergic treatment, the severity of PD symptoms using Unified Parkinson's Disease Rating Scale (UPDRS), and Hoehn-Yahr scale. Additionally, all participants were evaluated through a set of scales for specific neuropsychiatric symptoms including depression, anxiety, apathy, fatigue, and sleep disorders. A linear regression analysis was used with backward elimination. In the total explanatory model, for 12% of the variability in activity (R2 = 0.125; F(16.133) = 2.185; p < 0.01), the significant predictor was starting therapy with the dopamine agonist (DA) (β= 0.420; t= 4.068; p = 0.000), which was associated with a longer duration of moderate PA. In the total explanatory model, for more than 13% of the variance in time spent sitting (R2 = 0.135; F(16.130) = 2.267; p < 0.01), the significant predictors were secondary education and the results of the UPDRS. The patients with secondary and vocational education, those starting treatment with DA and those with a less severe degree of Parkinson's symptoms (UPDRS), spent less time sitting in a day. It is possible to identify determinants of spontaneous PA. It may elucidate consequences in terms of influence on modifiable conditions of PA and the proper approach to patients with unmodifiable PA factors.
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Self-Management Education for Persons with Parkinson's Disease and Their Care Partners: A Quasi-Experimental Case-Control Study in Clinical Practice. PARKINSONS DISEASE 2020; 2020:6920943. [PMID: 32399171 PMCID: PMC7210533 DOI: 10.1155/2020/6920943] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 03/31/2020] [Accepted: 04/15/2020] [Indexed: 11/25/2022]
Abstract
Background Parkinson's disease is a neurodegenerative condition with both physical and mental consequences that affect many aspects of everyday life. Persons with Parkinson's disease and their care partners want guidance from healthcare services in order to develop skills to adjust to life with a long-term condition. The Swedish National Parkinson School is a dyadic self-management programme to support both persons with Parkinson's disease and care partners. Objective To assess the outcomes of the Swedish National Parkinson School as reported by participants. Design A quasi-experimental case-control study in clinical care using self-reported questionnaires. Participants. Swedish National Parkinson School was offered by health care professionals working in clinical care. Participants in the programme were also asked to participate in the study. A matched control group was recruited for a comparison of findings. In total, 92 persons with Parkinson's disease and 55 care partners were included. Settings. Five Swedish geriatric and neurologic outpatient clinics. Method Data were collected during 2015–2017, before and after participation in the National Parkinson School or before and after seven weeks of standard care. Outcomes were assessed using generic and Parkinson's specific questionnaires. Descriptive statistics were used to describe baseline characteristics. Mann–Whitney U and Chi2 tests were used to test for between-group differences and within-group differences were tested by the Wilcoxon signed-ranks test. Results Improvements regarding health status, constructive attitudes and approaches, and skill and technique acquisition were found after the intervention among persons with Parkinson's disease. No changes were found among care partners. Conclusion The findings indicate that the Swedish National Parkinson School may improve health status and self-management among persons with Parkinson's disease, but further studies are needed to better understand the effects of the programme.
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Li T, Shi J, Qin B, Fan D, Liu N, Ni J, Zhang T, Zhou H, Xu X, Wei M, Zhang X, Wang X, Liu J, Wang Y, Tian J. Increased substantia nigra echogenicity correlated with visual hallucinations in Parkinson's disease: a Chinese population-based study. Neurol Sci 2019; 41:661-667. [PMID: 31754876 PMCID: PMC7039836 DOI: 10.1007/s10072-019-04110-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Accepted: 10/15/2019] [Indexed: 01/03/2023]
Abstract
As a noninvasive technique, transcranial sonography (TCS) of substantia nigra (SN) has gradually showed its effectiveness not only in diagnosis but also in understanding clinical features of Parkinson’s Disease (PD). This study aimed to further evaluate TCS for clinical diagnosis of PD, and to explore the association between sonographic manifestations and visual hallucinations (VH). A total of 226 subjects including 141 PD patients and 85 controls were recruited. All participants received TCS. A series of rating scales to evaluate motor and non-motor symptoms were performed in PD patients. Results showed that 172 subjects were successfully assessed by TCS. The area of SN was greater in PD patients than that in controls (P < 0.001). As receiver-operating characteristic (ROC) curve analysis showed, the best cutoff value for the larger SN echogenicity size was 23.5 mm2 (sensitivity 70.3%, specificity 77.0%). Patients with VH had larger SN area (P = 0.019), as well as higher Non-Motor Symptoms Scale (NMSS) scores (P = 0.018). Moreover, binary logistic regression analysis indicated that SN hyperechogenicity (odds ratio = 4.227, P = 0.012) and NMSS scores (odds ratio = 0.027, P = 0.042) could be the independent predictors for VH. In conclusion, TCS can be used as an auxiliary diagnostic tool for Parkinson’s disease. Increased SN echogenicity is correlated with VH in Parkinson’s disease, possibly because the brain stem is involved in the mechanism in the onset of VH. Further studies are needed to confirm these findings.
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Affiliation(s)
- Ting Li
- The Neurology Center, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, 100700, China
| | - Jing Shi
- The Neurology Center, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, 100700, China
| | - Bin Qin
- Beijing Hospital, Beijing, 100730, China
| | - Dongsheng Fan
- Peking University Third Hospital, Beijing, 100191, China
| | - Na Liu
- Peking University Third Hospital, Beijing, 100191, China
| | - Jingnian Ni
- The Neurology Center, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, 100700, China
| | - Tianqing Zhang
- The Neurology Center, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, 100700, China
| | - Hufang Zhou
- The Neurology Center, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, 100700, China
| | - Xiaoqing Xu
- The Neurology Center, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, 100700, China
| | - Mingqing Wei
- The Neurology Center, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, 100700, China
| | - Xuekai Zhang
- The Neurology Center, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, 100700, China
| | - Xiangzhu Wang
- The Neurology Center, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, 100700, China
| | - Jianping Liu
- Center for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, 100029, China
| | - Yongyan Wang
- Institute of Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, 100700, China
| | - Jinzhou Tian
- The Neurology Center, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, 100700, China.
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Effects of Fatigue on Balance in Individuals With Parkinson Disease: Influence of Medication and Brain-Derived Neurotrophic Factor Genotype. J Neurol Phys Ther 2019; 42:61-71. [PMID: 29547479 DOI: 10.1097/npt.0000000000000213] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND AND PURPOSE Because falls can have deleterious consequences, it is important to understand the influence of fatigue and medications on balance in persons with Parkinson disease (PD). Thus, the purpose of this study was to investigate the effects of fatigue on balance in individuals with PD. Because brain-derived neurotrophic factor (BDNF) has been shown to be related to motor performance, we also explored its role. METHODS A total of 27 individuals (age = 65.4 ± 8.1 years; males = 14, females = 13) with neurologist-diagnosed PD with 13 genotyped for BDNF as Val66Val, 11 as Val66Met, 2 as Met66Met (1 refused). Participants were tested both on and off medication, 1 week apart. On both days, they completed a pre- and posttest separated by a fatiguing condition. Factorial analyses of variance were performed for the following balance domains: (1) anticipatory postural responses; (2) adaptive postural responses; (3) dynamic balance; (4) sensory orientation; and (5) gait kinematics. For BDNF, t-tests were conducted comparing genotype for the pre-post difference scores in both the on and off medication states. RESULTS There were no interactions between time (pre- and postintervention) and medication for any of the domains (Ps ≥ 0.187). Participants with BDNF Met alleles were not significantly different from Val66Val participants in balance (Ps ≥ 0.111) and response to a fatiguing condition (Ps ≥ 0.070). DISCUSSION AND CONCLUSIONS Fatigue does not appear to have a detrimental effect on balance, and there was not a differential effect of medication in individuals with PD. These results also indicate that participants with a BDNF Met allele did not have a greater decay in function after a fatiguing condition.Video Abstract available for more insights from the authors (see Video, Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A196).
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Fatigue in Parkinson's disease: Italian validation of the Parkinson Fatigue Scale and the Fatigue Severity Scale using a Rasch analysis approach. Parkinsonism Relat Disord 2019; 65:105-110. [DOI: 10.1016/j.parkreldis.2019.05.028] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Revised: 04/17/2019] [Accepted: 05/19/2019] [Indexed: 12/14/2022]
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Martinez-Martin P, Wetmore JB, Arbelo JM, Catalán MJ, Valldeoriola F, Rodriguez-Blazquez C. Validation study of the Parkinson's Fatigue Scale in advanced Parkinson's disease. PATIENT-RELATED OUTCOME MEASURES 2019; 10:141-152. [PMID: 31114412 PMCID: PMC6497829 DOI: 10.2147/prom.s196042] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Accepted: 03/12/2019] [Indexed: 11/29/2022]
Abstract
Purpose: To validate the Parkinson’s Fatigue Scale (PFS-16) in advanced Parkinson Disease (APD) patients using the scale’s Spanish version. Patients and methods: In a clinical study for Levodopa-Carbidopa Intestinal Gel (LCIG), 59 patients were assessed over six months using the PFS-16 and other instruments. The psychometric properties of the PFS-16 were then analyzed. Results: Patients (60.7% men) were aged 68.02±7.43 years. PD duration was 12.57±5.97 years. Median Hoehn and Yahr (HY) stage of patients in “on” was 2 (range: 1–4). There were excellent data quality and acceptability for the PFS-16 as a whole, except for moderate-to-high ceiling effects in its items. Two factors explained 67% of the variance, yet parallel analysis demonstrated the unidimensional nature of the PFS-16, whose internal consistency was satisfactory (Cronbach’s alpha=0.93; item homogeneity coefficient=0.19, and item total-corrected correlations=0.50–0.84). PFS-16 total score showed moderate-to-high correlations with fatigue-specific questions within clinical tools, namely item 20 of the Beck Depression Inventory (rS=0.65) and item 4 of the Non-Motor Symptoms Scale (rS=0.33). Weak-to-moderate correlations were observed between the PFS-16 and measures of anxiety, depression, apathy, and quality of life. There were no significant differences in PFS-16 total scores when grouped by age, sex, time from diagnosis, HY, and CGI-S. After treatment with LCIG, the relative change in PFS-16 total score was −17.6% and the effect size (Cohen’s d) was 0.92. Moderate correlations between changes in the PFS-16 and several other clinical tools were also found. Conclusion: In APD patients, the PFS-16 showed satisfactory acceptability, internal consistency, construct validity, and responsiveness.
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Affiliation(s)
- Pablo Martinez-Martin
- National Center of Epidemiology, Carlos III Institute of Health, Madrid, Spain.,Center for Networked Biomedical Research in Neurodegenerative Diseases (CIBERNED), Carlos III Institute of Health, Madrid, Spain
| | - John B Wetmore
- National Center of Epidemiology, Carlos III Institute of Health, Madrid, Spain
| | - José Matías Arbelo
- Movement Disorders Unit, Hospital Universitario Insular de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | | | | | - Carmen Rodriguez-Blazquez
- National Center of Epidemiology, Carlos III Institute of Health, Madrid, Spain.,Center for Networked Biomedical Research in Neurodegenerative Diseases (CIBERNED), Carlos III Institute of Health, Madrid, Spain
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The Parkinson fatigue scale: an evaluation of its validity and reliability in Greek Parkinson’s disease patients. Neurol Sci 2019; 40:683-690. [DOI: 10.1007/s10072-018-3695-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2018] [Accepted: 12/31/2018] [Indexed: 01/25/2023]
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12
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A High-Intensity Exercise Boot Camp for Persons With Parkinson Disease: A Phase II, Pragmatic, Randomized Clinical Trial of Feasibility, Safety, Signal of Efficacy, and Disease Mechanisms. J Neurol Phys Ther 2019; 43:12-25. [DOI: 10.1097/npt.0000000000000249] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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13
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Shi J, Tian J, Li T, Qin B, Fan D, Ni J, Wei M, Zhang X, Liu N, Liu J, Li Y, Liu W, Wang Y. Efficacy and safety of SQJZ herbal mixtures on nonmotor symptoms in Parkinson disease patients: Protocol for a randomized, double-blind, placebo-controlled trial. Medicine (Baltimore) 2017; 96:e8824. [PMID: 29390272 PMCID: PMC5815684 DOI: 10.1097/md.0000000000008824] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND As a multisystemic neurodegenerative disorder, Parkinson disease (PD) has a broad spectrum of symptoms including motor and nonmotor symptoms (NMS). As shown in studies, NMS can also impact patient's quality of life, and many of them often go untreated. Chinese herbal medicines with multiconstituent may alleviate NMS in PD patients. This research is carried out to assess the efficacy and safety of a Chinese herbal formula for NMS, with its Chinese name acronym of SQJZ. METHODS/DESIGN It will be a multicenter, randomized, double-blind, placebo-controlled trial. Idiopathic PD with a Hoehn and Yahr scale score ≤4, aged 18 to 80 years, will be involved. About 240 patients will be randomly assigned to either SQJZ or placebo in a 2:1 ratio. There is a 2-week run-in period before the randomization, and the follow-up will be 24 weeks, including 12-week treatment period, with visit once every 4 weeks and 12-week washout follow-up. All participants are asked to maintain the regular medication schedule. SQJZ formula will consist of Chinese herbs with effects for insomnia, constipation, anxiety, and so on. The primary outcome will be measured using NMS scale, and secondary outcomes will include unified PD rating scale, PD sleep scale, the Parkinson fatigue scale, the constipation severity instrument, and PD Questionnaire-39. The primary efficacy analysis will be based on the intention-to-treat method, and mixed-model repeated-measures analyses will be used. DISCUSSION The findings from this research might provide evidence of the efficacy and safety of SQJZ Chinese herbal formula for treating NMS in PD patients. The results will sustain the broader use of SQJZ formula in PD.
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Affiliation(s)
- Jing Shi
- Institute of Neurodegenerative Diseases at Dongzhimen Hospital, Beijing University of Chinese Medicine
| | - Jinzhou Tian
- Institute of Neurodegenerative Diseases at Dongzhimen Hospital, Beijing University of Chinese Medicine
| | - Ting Li
- Institute of Neurodegenerative Diseases at Dongzhimen Hospital, Beijing University of Chinese Medicine
| | | | | | - Jingnian Ni
- Institute of Neurodegenerative Diseases at Dongzhimen Hospital, Beijing University of Chinese Medicine
| | - Mingqing Wei
- Institute of Neurodegenerative Diseases at Dongzhimen Hospital, Beijing University of Chinese Medicine
| | - Xuekai Zhang
- Institute of Neurodegenerative Diseases at Dongzhimen Hospital, Beijing University of Chinese Medicine
| | - Na Liu
- Peking University Third Hospital
| | - Jianping Liu
- Center for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine
| | - Yumeng Li
- Institute of Neurodegenerative Diseases at Dongzhimen Hospital, Beijing University of Chinese Medicine
| | - Weiwei Liu
- Consulting Center of Biomedical Statistics, The Academy of Military Medical Sciences
| | - Yongyan Wang
- Institute of Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, China
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Systematic content evaluation and review of measurement properties of questionnaires for measuring self-reported fatigue among older people. Qual Life Res 2015; 24:2239-55. [PMID: 25778536 DOI: 10.1007/s11136-015-0963-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/11/2015] [Indexed: 10/23/2022]
Abstract
PURPOSE The assessment of fatigue in older people requires simple and user-friendly questionnaires that capture the phenomenon, yet are free from items indistinguishable from other disorders and experiences. This study aimed to evaluate the content, and systematically review and rate the measurement properties of self-report questionnaires for measuring fatigue, in order to identify the most suitable questionnaires for older people. METHODS This study firstly involved identification of questionnaires that purport to measure self-reported fatigue, and evaluation of the content using a rating scale developed for the purpose from contemporary understanding of the construct. Secondly, for the questionnaires that had acceptable content, we identified studies reporting measurement properties and rated the methodological quality of those studies according to the COSMIN system. Finally, we extracted and synthesised the results of the studies to give an overall rating for each questionnaire for each measurement property. The protocol was registered with PROSPERO (CRD42013005589). RESULTS Of the 77 identified questionnaires, twelve were selected for review after content evaluation. Methodological quality varied, and there was a lack of information on measurement error and responsiveness. CONCLUSIONS The PROMIS-Fatigue item bank and short forms perform the best. The FACIT-Fatigue scale, Parkinsons Fatigue Scale, Perform Questionnaire, and Uni-dimensional Fatigue Impact Scale also perform well and can be recommended. Minor modifications to improve performance are suggested. Further evaluation of unresolved measurement properties, particularly with samples including older people, is needed for all the recommended questionnaires.
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15
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Psychometric properties of four fear of falling rating scales in people with Parkinson's disease. BMC Geriatr 2014; 14:66. [PMID: 24884466 PMCID: PMC4035736 DOI: 10.1186/1471-2318-14-66] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2014] [Accepted: 05/06/2014] [Indexed: 11/26/2022] Open
Abstract
Background Fear of falling (FOF) is commonly experienced in people with Parkinson’s disease (PD). It is a predictor of recurrent falls, a barrier to physical exercise, and negatively associated with health-related quality of life. A variety of rating scales exist that assess different aspects of FOF but comprehensive head-to-head comparisons of their psychometric properties in people with PD are lacking. The aim of this study was to evaluate the psychometric properties of four FOF rating scales in people with PD. More specifically, we investigated and compared the scales’ data completeness, scaling assumptions, targeting, and reliability. Methods The FOF rating scales were: the Falls Efficacy Scale-International (FES-I), the Swedish FES (FES(S)), the Activities-specific Balance Confidence scale (ABC), and the modified Survey of Activities and Fear of Falling in the Elderly (mSAFFE). A postal survey was administered to 174 persons with PD. Responders received a second survey after two weeks. Results The mean (SD) age and PD duration of the 102 responders were 73 (8) and 7 (6) years, respectively. ABC had worse data completeness than the other scales (6.9 vs. 0.9–1.3% missing data). All scales had corrected item-total correlations exceeding 0.4 and showed acceptable reliabilities (Cronbach’s alpha and Intraclass Correlation Coefficient (ICC) >0.80) but only FES-I had ICC >0.90. The standard error of measurements ranged from 7% (FES-I) to 12% (FES(S)), and the smallest detectable differences ranged from 20% (FES-I) to 33% (FES(S)) of the total score ranges. ABC and FES(S) had substantially more outliers than mSAFFE and FES-I (10 and 15 vs. 3 and 4, respectively) when the two test occasions were compared. Conclusions When assessing FOF in people with PD, the findings in the present study favoured the choice of FES-I or mSAFFE. However, FES-I was the only scale with ICC >0.90 which has been suggested as a minimum when using a scale for individual comparisons.
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16
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Chen HF, Wu CY, Lin KC, Jang Y, Lin SC, Cheng JW, Chung CY, Yan Y. Measurement properties of streamlined wolf motor function test in patients at subacute to chronic stages after stroke. Neurorehabil Neural Repair 2014; 28:839-46. [PMID: 24627334 DOI: 10.1177/1545968314526643] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
UNLABELLED BACKGROUND. Previous research using the streamlined Wolf Motor Function Test (SWMFT) has focused either on the 3- to 9-month period or on the >12-month period after stroke and lacked the information for those at 9 to 12 months. Whether SWMFT scores reflect motor deficit and recovery from early to late stages after stroke remains unclear. OBJECTIVE A retrospective study using the Functional Ability Scale (FAS) was conducted to evaluate whether all SWMFTs items measure the poststroke recovery of upper extremity (UE) motor function and if they could be used for patients within 9 to 12 months after a stroke. METHODS Rasch analysis was conducted, and data were drawn from patients 3 months to years after a stroke. RESULTS The continuum of UE motor function in SWMFT-FAS was supported. Subacute patients had the best motor function, followed by the 9- to 12-month group, and then chronic patients. Variation in UE motor function was large (2.35-2.72 logits), and motor abilities of these 3 groups overlapped. The 8 SWMFT items could target a broad range of UE motor function, from -8.28 to 7.80 logits. The average difficulty of these 8 items also matched the UE motor ability of the subgroup at 9 to 12 months after stroke, and individual versions of the SWMFT performed well to assess the motor ability of this group. CONCLUSIONS The SWMFTs had sound hierarchical properties. The SWMFT-Chronic or the SWMFT-Subacute could be used to evaluate UE function of this subgroup at 9 to 12 months after stroke.
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Affiliation(s)
- Hui-Fang Chen
- City University of Hong Kong, Hong Kong, SAR Hong Kong Institute of Education, Hong Kong, SAR
| | | | - Keh-Chung Lin
- National Taiwan University, Taipei, Taiwan National Taiwan University Hospital, Taipei, Taiwan
| | - Yuh Jang
- National Taiwan University, Taipei, Taiwan National Taiwan University Hospital, Taipei, Taiwan
| | | | | | | | - Yanning Yan
- Hebei General Hospital, Shijiazhuang, Hebei Province, China
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Kapoor S. Parkinson's disease-associated fatigue: emerging new therapeutic options. J Pain Symptom Manage 2014; 47:e6-7. [PMID: 24417805 DOI: 10.1016/j.jpainsymman.2013.11.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2013] [Accepted: 11/03/2013] [Indexed: 11/15/2022]
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18
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Lu YM, Wu YY, Hsieh CL, Lin CL, Hwang SL, Cheng KI, Lue YJ. Measurement precision of the disability for back pain scale-by applying Rasch analysis. Health Qual Life Outcomes 2013; 11:119. [PMID: 23866814 PMCID: PMC3717282 DOI: 10.1186/1477-7525-11-119] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2012] [Accepted: 07/12/2013] [Indexed: 12/21/2022] Open
Abstract
Background The Oswestry Disability Index (ODI) is widely used for patients with back pain. However, few studies have examined its psychometric properties using modern measurement theory. The purpose of this study was to investigate the psychometric properties of the ODI in patients with back pain using Rasch analysis. Methods A total of 408 patients with back pain participated in this cross-sectional study. Patients were recruited from the orthopedic, neurosurgery, rehabilitation departments and pain clinic of two hospitals. Rasch analysis was used to examine the Chinese version of ODI 2.1 for unidimensionality, item difficulty, category function, differential item functioning, and test information. Results The fit statistics showed 10 items of the ODI fitted the model’s expectation as a unidimensional scale. The ODI measured the different levels of functional limitation without skewing toward the lower or higher levels of disability. No significant ceiling and floor effects and gaps among the items were found. The reliability was high and the test information curve demonstrated precise dysfunction estimation. Conclusions Our results showed that the ODI is a unidimensional questionnaire with high reliability. The ODI can precisely estimate the level of dysfunction, and the item difficulty of the ODI matches the person ability. For clinical application, using logits scores could precisely represent the disability level, and using the item difficulty could help clinicians design progressive programs for patients with back pain.
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Affiliation(s)
- Yen-Mou Lu
- Department of Orthopaedics, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
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