Analysis of functional profile and mobility in Parkinson’s disease: a cross sectional study

Abstract

Background: Idiopathic Parkinson’s disease (PD) is a progressive neurodegenerative disease that has a prevalence of 18–328 per 100,000 in habitants in developing countries, with an estimated 3.3% of the Brazilian elderly population affected by PD throughout life. The classic symptoms include a resting tremor, muscular rigidity, bradykinesia and postural instability, which are all motor symptoms. The mobility of the subjects is compromised early, thus impairing their balance and limiting their ability to perform simple tasks. The restricted movement prevents dissociation between the head and trunk during walking, and freezing occurs as advanced disease reduces the progression of movements during walking. Objective: To analyze mobility and functionality profiles in subjects with Parkinson’s disease and compare them with healthy subjects. Method: A sample was consisted of 10 subjects with PD and 10 healthy elderly subjects. Assessment tools were used to quantify the severity of PD the scale Hoehn and Yah (HY), for mobility were used the Dynamic Parkinson’s Gait Scale (DYPAGS) and Modified Parkinson Activity Scale (PAS modified), for functionality were used the Unified Parkinson’s Disease Rating Scale (UPDRS) and dual task (DT) performance. Results: The subjects with PD showed worse performance in mobility and DT as determined by the modified PAS (p=0.0001) and DYPAGS (p=0.0001). Correlations were found between the UPDRS, the Gait Freezing Questionnaire (FOG), the PAS modified score, left-hand grip strength and the HY values (p<0.05). There were no differences in prehensile muscle strength between PD and healthy subjects. Conclusions: Subjects with PD showed decreased mobility and functionality for activities related to ADLs, gait and DT compared to healthy elderly subjects. Disease severity, muscle strength and freezing were correlated with the mobility and DT performance in subjects with PD.

Muscle Strength and Power in People With Parkinson Disease: A Systematic Review and Meta-analysis

“…Ultimately, 40 studies fulfilled the inclusion criteria and were subdivided into aims 1 (n = 2), 2 (n = 40), and 3 (n = 11), respectively. Two studies22,23 reported relevant outcomes for both aim 1 and aim 2, while 11 studies6,24–34 reported relevant outcomes for both aim 2 and aim 3. The quality assessment of individual studies is reported in Supplemental Digital Content 2, Table 1b, available at: http://links.lww.com/JNPT/A404.…”

Functional mobility in Parkinson’s disease: associations with motor and non-motor symptoms

“…15,27 Studies have proven the effect of health-related conditions and PD progression on FM, such as multiple-system comorbidity, 24 sedentary behavior, 7 and severity of PD symptoms. 2,4 Linear and angular acceleration were reduced in individuals with PD when compared to healthy subjects, which determined a diminished movement smoothness and time to complete TUG. 4 more In addition, a reduction in the trunk flexion, extension, and right/left rotation active range of motion affected the time spent on the TUG.…”

“…1 Several studies have proven that this ability is decreased in individuals with Parkinson's disease (PD). [2][3][4][5] Multiple factors may contribute to the FM limitations in individuals with PD, including chronic medical conditions (e.g., psychiatric and musculoskeletal conditions); 6 sedentary behavior, 7 or disease severity. 2,4 Bradykinesia; resting tremor; rigidity and postural instability, which are PD cardinal features; as well as changes in posture and gait contribute to FM limitations.…”

“…[2][3][4][5] Multiple factors may contribute to the FM limitations in individuals with PD, including chronic medical conditions (e.g., psychiatric and musculoskeletal conditions); 6 sedentary behavior, 7 or disease severity. 2,4 Bradykinesia; resting tremor; rigidity and postural instability, which are PD cardinal features; as well as changes in posture and gait contribute to FM limitations. [2][3][4][5]8 In addition, PD is associated with non-motor symptoms, including neuropsychiatric disorders, autonomic dysfunction, sleep disorders, and sensory impairments that can cause progressive disability and an impact on one's quality of life.…”

“…2,4 Bradykinesia; resting tremor; rigidity and postural instability, which are PD cardinal features; as well as changes in posture and gait contribute to FM limitations. [2][3][4][5]8 In addition, PD is associated with non-motor symptoms, including neuropsychiatric disorders, autonomic dysfunction, sleep disorders, and sensory impairments that can cause progressive disability and an impact on one's quality of life. 9 However, few studies have investigated the relationship between non-motor symptoms and FM in individuals with PD.…”