The Association of Balance, Fear of Falling, and Daily Activities With Drug Phases and Severity of Disease in Patients With Parkinson

Telephone-based application of the Activities of Daily Living Questionnaire in patients with Parkinson's disease

BACKGROUND

 The Activities of Daily Living Questionnaire (ADLQ) focuses on assessing the ability to perform activities of daily living (ADLs) based on the self-perception of individuals with Parkinson's disease (PD). A Brazilian Portuguese version of the questionnaire is available (ADLQ-Brazil), and further investigation is needed to fully assess its measurement properties.

OBJECTIVE

 To investigate construct and concurrent validity of the telephone-based administration of the ADLQ-Brazil with community individuals with PD.

METHODS

 There were 50 adults with PD (mean age: 68 ± 9.5 years) invited to answer the ADLQ-Brazil on two randomized occasions, face-to-face and by telephone, 7 to 10 days apart. Clinical-based measures including the Movement Disorder Society-Sponsored Revision of the Unified Parkinson Disease Rating Scale, Timed Up and Go Test, Nine Hole Peg Test, Mini-Balance Evaluation Systems Test, Apathy Scale, Beck Depression Inventory, Modified Fatigue Impact Scale, and Parkinson Disease Quality of Life Questionnaire were applied during the first session, to establish construct validity.

RESULTS

 The total scores on the ADLQ-Brazil were significantly associated with the clinical-based measures, thus providing evidence of construct validity. No significant differences were observed between the mean scores obtained with the face-to-face and telephone-based administration of the questionnaire (95%CI = 0.997). A high level of agreement was found in the total scores obtained between both applications of the ADLQ-Brazil (95%CI = 0.994-0.998), and most of the individual items had, on average, moderate agreement.

CONCLUSION

 The findings provide psychometric support for the ADLQ-Brazil as a telephone interview to assess the performance of ADLs in individuals with PD.

Psychometric Properties of the Persian Version of Penn Parkinson Daily Activities Questionnaire-15

Introduction

Appropriate information about the ability of patients with Parkinson disease (PD) to perform cognitive instrumental activities of daily living (IADL) is necessary. The present study aimed to assess the psychometric properties of the Persian version of the Penn Parkinson daily activities questionnaire-15 (PDAQ-15).

Methods

A total of 165 knowledgeable informants of PD patients completed the PDAQ-15. The clinical dementia rating scale, Hoehn and Yahr staging, hospital anxiety and depression scale (HADS), and Lawton IADL scale were used in the study. Internal consistency and test-retest reliability were evaluated by the Cronbach α coefficient and intraclass correlation coefficient (ICC), respectively. To examine the dimensionality of the questionnaire, exploratory factor analysis was used. The construct validity was assessed using the Spearman rank correlation test. To assess the discriminative validity, PDAQ-15 scores were compared across cognitive stages.

Results

The PDAQ-15 showed strong internal consistency (the Cronbach α=0.99) and test-retest reliability (ICC= 0.99). Only one dimension was identified for the PDAQ-15 in the factor analysis. There was a strong correlation between PDAQ-15 with the depression domain of the HADS scale and the Lawton IADL scale (rs=|0.71-0.95|). The correlation of PDAQ-15 with the anxiety domain of the HADS scale was moderate (rs=0.66). Discriminative validity analysis showed that the PDAQ-15 has significant power to discriminate between PD patients across cognitive stages.

Conclusion

These results suggest that the PDAQ-15 is a valid and reliable PD-specific instrument and can be useful in clinical and research settings.

Psychological Factors Associated With Fear of Falling Avoidance Behavior in Parkinson's Disease: The Role of Depression, Anxiety, and Catastrophizing

PURPOSE

The purpose of this study was to examine the relationship between psychological factors (depression, anxiety, and catastrophizing) and fear of falling avoidance behavior (FFAB) among individuals with Parkinson's disease (PD).

METHODS

A secondary analysis of cross-sectional data from 59 individuals with PD using hierarchical multiple regression.

RESULTS

Disease severity (Movement Disorder Society - Unified PD Rating Scale) and catastrophizing (Consequences of Falling Questionnaire (CoF)) explained approximately 48.2% of the variance in the FFAB Questionnaire scores (P < .001). Catastrophizing was the only significant psychological variable (P < .001). The damage to identity subscale of the CoF was significant in the final model (P < .001).

CONCLUSIONS

Catastrophizing about the consequences of falls explained the largest portion of variability in FFAB after controlling for disease severity. Catastrophizing about the immediate consequences of falling may play a prominent role in FFAB and may be a potential treatment target for mitigating FFAB.

Motor control times and strategies in left- and right-handed participants: Behavioral evidence for the hemispheric distribution of motor planning

Background: There is conflicting evidence in favor of the hemispheric distribution of motor planning. Some studies supported the left-hemisphere-dominance hypothesis for motor planning and claimed that the left-hemisphere has a crucial function in motor control even in left-handers. The present study aimed to compare the right- and left-handed participants on motor planning ability and to investigate the performance of their dominant hands in a specific action selection task. Also, the effect of task complexity was assessed. Methods: Twenty right-handers and 20 left-handers performed an action selection task. The participants had to grasp a hexagonal knob with their dominant hand and consequently rotated it 60° or 180 ° clockwise or counterclockwise. Depending on our objects, we used mixed factorial ANOVA and the groups were examined in terms of the planning time, grasping time, releasing time and planning pattern for initial grip selection. The SPSS 19 was used for analyzing the data and p≤0.05 was considered as the significant level. Results: No significant differences were observed between the two groups. The movement-related measures revealed a main effect of rotation (p˂0.001). However, a significant interaction between direction × planning pattern × group (p˂0.001) indicated a preferential bias for rotatory movements in the medial direction which is consistent with the "medial over lateral advantage". Conclusion: Both left- and right-handed participants had a similar motor planning ability while performing a planning task with their dominant hands. Because our study was behavioral, it only provided a test of the left-hemisphere hypothesis of motor planning.

Relationship between Motor Estimation Error and Physical Function in Patients with Parkinson's Disease

Background: Motor estimation error is an index of how accurately one's body movement is recognized. This study determines whether motor estimation error distance is a Parkinson's disease (PD)- or age-related disability using a two-step task. Methods: The participants were 19 PD patients and 58 elderly people with disabilities. A two-step prediction test and an actual two-step test were performed. The motor estimation error distance (prediction of two-step distance minus actual two-step distance) and error rate between the two groups were compared. We conducted a correlation analysis between the motor estimation error and clinical factor (e.g., Hoehn and Yahr stage (H & Y), Unified Parkinson's Disease Rating Scale (UPDRS)) related to PD. Results: The motor estimation error distance was not significantly different between the PD patient group and the elderly group with disabilities. However, significant correlations between motor estimation error and H & Y, and between motor estimation error and UPDRS part II, were observed. The error rate was significantly correlated with the Fall Efficacy Scale. Conclusions: The motor estimation error distance is influenced by both aging and PD.