Factors Contributing to Perceived Walking Difficulties in People with Parkinson’s Disease

Kader, Manzur; Ullén, Susann; Iwarsson, Susanne; Odin, Per; Nilsson, Maria H

doi:10.3233/jpd-161034

Cited by 33 publications

(39 citation statements)

References 63 publications

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“…One study used both PFS and FSS with a cut‐off point of ≥ 3.3 and of > 4, respectively . The two studies using Multidimensional Fatigue Inventory (MFI) used a cut‐off point of ≥ 13 (see Revees and colleagues for cut‐off reference), and four studies adopting the Energy subscale of Nottingham Health Profile (NHP‐EN) classified as having fatigue patients who affirmed at least one of three dichotomous (Yes/No) questions (i.e., tired all the time, everything is an effort, soon out of energy; see Hagell and colleagues for cut‐off reference) . One study measured fatigue prevalence by Fatigue Questionnaire (FQ) with a cut‐off point of ≥ 4 (see Loge and colleagues for cut‐off reference), and one study measured fatigue prevalence by SEND‐PD using a cut‐off point of > 0 (see Martinez‐Martin and colleagues for cut‐off reference).…”

Section: Resultsmentioning

confidence: 99%

Fatigue in Parkinson's disease: A systematic review and meta‐analysis

et al. 2018

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We conducted a systematic review and meta‐analysis aimed at establishing robust prevalence estimates and identifying clinical correlates of fatigue in PD. From 2,459 titles and abstracts, we selected 44 relevant studies (n = 7427 patients). Overall, the meta‐analysis showed a prevalence of fatigue of 50% in PD. This prevalence estimate, however, was significantly moderated by study heterogeneity in measurement scales and cut‐off thresholds. In contrast, demographic features, disease severity, cognitive impairment, and depression did not moderate prevalence estimates. Moreover, fatigue prevalence did not differ between de novo and treated PD patients. Compared to nonfatigued patients, fatigued patients had sligthly higher age (1.44 years), disease duration (0.93 years), l‐dopa equivalent daily dose (50.89 units), UPDRS‐III (4.99 points), and H & Y (0.33 points), as well as risk of comorbid depression (risk ratio = 1.89) and had a little lower MMSE score (–0.66 points). Fatigue was moderately associated with apathy (Hedges' g = 0.55), anxiety (Hedges' g = 0.67), daytime somnolence (Hedges' g = 0.43), sleep disturbances (Hedges' g = 0.66), and poorer quality of life (Hedges' g = 1.23). Our analyses suggest that fatigue is a frequent, independent nonmotor symptom in PD appearing early and persisting throughout the disease course, and that establishing uniform diagnostic criteria for PD‐related fatigue is critical. In addition, several nonmotor symptoms appear to be associated with fatigue and negatively impact quality of life. Pharmacological and nonpharmacological interventions targeting fatigue and associated symptoms may improve quality of life in patients with PD. © 2018 International Parkinson and Movement Disorder Society

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Section: Resultsmentioning

confidence: 99%

Fatigue in Parkinson's disease: A systematic review and meta‐analysis

et al. 2018

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“…Outpatient participants were recruited from three hospitals in southern Sweden (see Figure 1, which presents a flowchart of the recruitment process). Details of recruitment and follow-up procedures have been described before, i.e., for baseline [26] and the 3year follow-up [27]. At baseline, 653 persons met the inclusion criterion of a PD diagnosis (ICD10-code G20.9), since at least one year.…”

Section: Participants and Recruitmentmentioning

confidence: 99%

Predictive Factors of Concerns about Falling in People with Parkinson’s Disease: A 3-Year Longitudinal Study

Lindh-Rengifo

Jonasson

Mattsson

et al. 2019

Parkinson's Disease

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Introduction. Fear of falling (FOF) is more common in people with Parkinson's disease (PD) than in healthy controls. It can lead to several negative consequences such as restrictions in everyday life. Moreover, FOF is a risk factor for future falls. Aim. is study aimed to identify predictive factors of FOF (conceptualized as concerns about falling) after three years, with and without adjusting for concerns about falling at baseline, in people with PD. Methods. is study included 151 participants (35% women) with PD. At baseline, their mean (SD) age and PD duration were 68 (±9.0) and 9 (±6.1) years, respectively. e Falls Efficacy Scale-International (FES-I) was used as the dependent variable in multivariable linear regression analyses. Results. e mean (SD) FES-I score increased from 28.1 (11.9) to 33.1 (14.0) three years later (p < 0.001). e strongest (according to the standardized regression coefficient, β) predictor of concerns about falling was walking difficulties (β � 0.378), followed by age (0.227), problems maintaining balance while dual tasking (0.172), and needing help in daily activities (0.171). When adjusting for baseline FES-I scores, the strongest predictive factor was problems maintaining balance while dual tasking (β � 0.161), which was followed by age (0.131) and female sex (0.105). Conclusions. is study pinpoints several predictive factors of concerns about falling that are modifiable and which could be addressed in rehabilitation: perceived walking difficulties, having problems maintaining balance while dual tasking, and dependence on others in daily activities. e importance of dual tasking is a novel finding, which future studies need to confirm or refute. One should be aware of the fact that an increased age predicts concerns about falling with and without adjusting for baseline FES-I scores, whereas female sex predicts concerns about falling only when adjusting for baseline FES-I scores.

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“…The Walk-12G is a patient-reported outcome that assesses perceived walking difficulties during everyday life, which cannot be captured by performance-based measures alone. It has previously been shown that the Walk-12G does not solely reflect walking capacity, but is largely influenced by nonmotor factors such as self-efficacy and depressive symptoms as well as self-reported freezing of gait and fatigue (Kader, Ullen, Iwarsson, Odin, & Nilsson, 2017). This is a recognized attribute of patient-reported as opposed to performance-based measures among elderly with disability, whereby patient-reported function can have stronger associations with psychosocial factors than with physical function (Bean, Olveczky, Kiely, LaRose, & Jette, 2011).…”

Section: Walk-12g Scores Correlated Significantly Withmentioning

confidence: 99%

Patient‐reported and performance‐based measures of walking in mild–moderate Parkinson's disease

et al. 2018

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BackgroundKnowledge of the relationships between patient‐reported and performance‐based walking measures in Parkinson's disease (PD) should inform clinical decision‐making. The Walk‐12G reliably captures perceived walking difficulties but has not been compared to performance‐based walking in laboratory or free‐living settings or across different groups.ObjectivesTo investigate the relationship between patient‐reported walking difficulties (Walk‐12G) and performance‐based walking in laboratory and free‐living conditions and to determine whether the Walk‐12G can distinguish between the subgroups, (i) people with/without PD and (ii) mild/moderate disease stages.MethodsForty‐seven people without and 49 people with PD (Hoehn and Yahr stage II and III) were assessed in relation to patient‐reported walking difficulties (Walk‐12G scale); spatiotemporal gait characteristics (Pace; Rhythm; Asymmetry; Variability; and Postural control) using a laboratory‐based electronic walkway; and walking behavior (mean steps/day and minutes of brisk walking/day) using accelerometers in free‐living conditions.ResultsThe Walk‐12G correlated moderately with the spatiotemporal domain step velocity (r = −0.46) and walking behavior, measured as mean steps/day (r = −0.46). Weaker correlations were observed for step length and minutes spent in brisk walking (r = −0.36 and r = −0.35, respectively). Poor correlations were observed for all other spatiotemporal domains. The Walk‐12G could distinguish between people with and without PD (Effect size, r = 0.82) and between those at mild/moderate disease stages (r = 0.34).ConclusionsPerceived walking difficulties showed weak to moderate associations with performance‐based measures of walking in mild–moderate PD. As the strongest associations were observed for step velocity and walking behavior, targeting these specific gait aspects could improve perceived walking difficulties in daily life.

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Factors Contributing to Perceived Walking Difficulties in People with Parkinson’s Disease

Abstract: (244 out of 250)Background: While walking difficulties are common in people with Parkinson's disease

Cited by 33 publications

References 63 publications

Fatigue in Parkinson's disease: A systematic review and meta‐analysis

Fatigue in Parkinson's disease: A systematic review and meta‐analysis

Predictive Factors of Concerns about Falling in People with Parkinson’s Disease: A 3-Year Longitudinal Study

Patient‐reported and performance‐based measures of walking in mild–moderate Parkinson's disease

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