Guidelines for Parkinson’s disease treatment: consensus from the Movement Disorders Scientific Department of the Brazilian Academy of Neurology - motor symptoms

Saba, Roberta Arb; Maia, Débora Palma; Cardoso, Francisco; Borges, Vanderci; Andrade, Luiz Augusto Franco de; Ferraz, Henrique Ballalai; Barbosa, Egberto Reis; Rieder, Carlos Roberto de Mello; Silva, Delson José da; Chien, Hsin Fen; Capato, Tamine; Rosso, Ana Lucia; Lima, Carlos Frederico Leite de Souza; Bezerra, José Marcelo Ferreia; Nicaretta, Denise Hack; Barsottini, Orlando Graziani Póvoas; Godeiro-Júnior, Clécio; Barcelos, Lorena Broseghini; Cury, Rubens Gisbert; Spitz, Mariana; Silva, Sônia Maria Cesar de Azevedo; Coletta, Marcus Vinicius Della

doi:10.1590/0004-282x-anp-2021-0219

Cited by 5 publications

(9 citation statements)

References 104 publications

(129 reference statements)

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“…The current guidelines for PD provide no strong recommendations to assess upper limb functionality, 12,13,[17][18][19] and there is no consensus about outcome measures to assess specific impairments that directly impact functional movements. However, studies have shown that it is possible to clinical assess other upper limb impairments, such as manual dexterity.…”

Section: Specific Impairments Which Directly Impact Functional Movementsmentioning

confidence: 99%

“…8,11 There is a gap of this instrument in clinical and rehabilitation fields that can reliably measure the upper limb functional capacity of a person with PD. Currently, there are no recommendations to assess upper limb functionality 12,13,[17][18][19] and standardized upper limb impairments assessment in PD. 1,3,12,13,18 Here, in this systematic review, we aimed:…”

Section: Introductionmentioning

confidence: 99%

“…Currently, there are no recommendations to assess upper limb functionality 12,13,[17][18][19] and standardized upper limb impairments assessment in PD. 1,3,12,13,18 Here, in this systematic review, we aimed:…”

Section: Introductionmentioning

confidence: 99%

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Clinical assessment of upper limb impairments and functional capacity in Parkinson's disease: a systematic review

Capato,

Rodrigues,

Cury

et al. 2023

Arq Neuropsiquiatr

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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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Section: Specific Impairments Which Directly Impact Functional Movementsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Clinical assessment of upper limb impairments and functional capacity in Parkinson's disease: a systematic review

Capato,

Rodrigues,

Cury

et al. 2023

Arq Neuropsiquiatr

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“…Based on this review, we propose an algorithm as a guide for the treatment of motor symptoms in PD Figure 1 , Moreover, it is important to mention three recently published guidelines with recommendations concerning the treatment of PD: the Canadian guideline 4 , the Brazilian guideline of the Movement Disorders Scientific Department of the Brazilian Academy of Neurology 74 and the American Academy of Neurology guideline 75 . They review the current evidence of available treatment options for PD.…”

Section: An Algorithm For the Treatment Of Motor Symptoms Of Pd And R...mentioning

confidence: 99%

How I treat Parkinson's disease

Barbosa

Limongi

Chien

et al. 2022

Arq. Neuro-Psiquiatr.

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Background: Parkinson’s disease (PD) is a complex neurodegenerative condition. Treatment strategies through all stages of disease progression could affect quality of life and influence the development of future complications, making it crucial for the clinician to be on top of the literature. Objective: This paper reviews the current treatment of PD, from early to advanced stages. Methods: A literature review was conducted focusing on the treatment of PD, in the different stages of progression. Results: Every individual with a new diagnosis of PD should be encouraged to start exercising regularly. In the early stage, treatment should focus on using the lowest dose of levodopa or combination therapy that provides maximum functional capacity, and does not increase the risk of complications, such as peak dose dyskinesias and impulse control disorders. At the moderate and advanced stages, motor fluctuations and complications of treatment dominate the picture, making quality of life one important issue. Rehabilitation programs can improve motor symptoms and should be offered to all patients at any stage of disease progression. Conclusion: Many factors need to be considered when deciding on the best treatment strategy for PD, such as disease progression, presence of risk factors for motor and behavioral complications, potential side effects from dopaminergic therapy and phenotypical variabilities. Treatment should focus on functional capacity and quality of life throughout the whole disease course.

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“…2 Although many resources are available for the management of PD motor symptoms, gait impairment only partially benefits from antiparkinsonian drug treatment and surgical intervention. 1,3 Assistive Technology (AT) is an umbrella term covering the systems and services related to the delivery of assistive products (AP) and services, enabling, and promoting the inclusion and participation of persons with disability, aging populations, and people with non-communicable diseases. Therefore, the use of AP may maintain or improve PD patients' functioning and independence, thereby promoting their well-being (WHO assistive -https://www.who.int/health-topics/assistive-technology#tab=tab_1).…”

Section: Introductionmentioning

confidence: 99%

Assisted technology in Parkinson's disease gait: what's up?

Capato,

Chen,

Miranda

et al. 2024

Arq Neuropsiquiatr

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Background Gait disturbances are prevalent and debilitating symptoms, diminishing mobility and quality of life for Parkinson's disease (PD) individuals. While traditional treatments offer partial relief, there is a growing interest in alternative interventions to address this challenge. Recently, a remarkable surge in assisted technology (AT) development was witnessed to aid individuals with PD. Objective To explore the burgeoning landscape of AT interventions tailored to alleviate PD-related gait impairments and describe current research related to such aim. Methods In this review, we searched on PubMed for papers published in English (2018-2023). Additionally, the abstract of each study was read to ensure inclusion. Four researchers searched independently, including studies according to our inclusion and exclusion criteria. Results We included studies that met all inclusion criteria. We identified key trends in assistive technology of gait parameters analysis in PD. These encompass wearable sensors, gait analysis, real-time feedback and cueing techniques, virtual reality, and robotics. Conclusion This review provides a resource for guiding future research, informing clinical decisions, and fostering collaboration among researchers, clinicians, and policymakers. By delineating this rapidly evolving field's contours, it aims to inspire further innovation, ultimately improving the lives of PD patients through more effective and personalized interventions.

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Guidelines for Parkinson’s disease treatment: consensus from the Movement Disorders Scientific Department of the Brazilian Academy of Neurology - motor symptoms

Cited by 5 publications

References 104 publications

Clinical assessment of upper limb impairments and functional capacity in Parkinson's disease: a systematic review

Clinical assessment of upper limb impairments and functional capacity in Parkinson's disease: a systematic review

How I treat Parkinson's disease

Assisted technology in Parkinson's disease gait: what's up?

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