The Clinically Important Difference on the Unified Parkinson's Disease Rating Scale

Shulman, Lisa M.; Gruber‐Baldini, Ann L.; Anderson, Karen E.; Fishman, Paul S.; Reich, Stephen G.; Weiner, William J.

doi:10.1001/archneurol.2009.295

Cited by 440 publications

(345 citation statements)

References 40 publications

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“…The substantial improvements at both 12 and 24 months in MDS-UPDRS III for the AT group exceed both the minimal detectable change and the substantial minimal clinically important difference for the MDS-UPDRS III. 28 As expected, the control group did not improve at any time point and actually had a 6-point worsening in MDS-UPDRS III score, although this was not significantly different from baseline. These findings agree with those reported in a previous randomized controlled trial that assessed individuals off anti-PD medication after participation in a year-long AT class.…”

Section: Discussionsupporting

confidence: 67%

Are the Effects of Community-Based Dance on Parkinson Disease Severity, Balance, and Functional Mobility Reduced with Time? A 2-Year Prospective Pilot Study

Duncan

Earhart

2014

The Journal of Alternative and Complementary Medicine

102

156

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"Are the effects of community-based dance on Parkinson disease severity, balance, and functional mobility reduced with time? A 2-year prospective pilot study." The Journal od Alternative and Complementary Medicine.20,10. 757-763. (2014 Results: There were no differences between groups at baseline. A significant group-by-time interaction (F [2,8] = 17.59; p < 0.0001) was noted for the MDS-UPDRS III, with the AT group having lower scores at 12 and 24 months than the controls. Significant interactions were also noted for the Mini-BESTest, MDS-UPDRS II and I, and 6MWT. Conclusion: This is believed to be one of the longest-duration studies to examine the effects of exercise on PD. Participation in community-based dance classes over 2 years was associated with improvements in motor and nonmotor symptom severity, performance on activities of daily living, and balance in a small group of people with PD. This is noteworthy given the progressive nature of PD and the fact that the control group declined on some outcome measures over 2 years.

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Section: Discussionsupporting

confidence: 67%

Are the Effects of Community-Based Dance on Parkinson Disease Severity, Balance, and Functional Mobility Reduced with Time? A 2-Year Prospective Pilot Study

Duncan

Earhart

2014

The Journal of Alternative and Complementary Medicine

102

156

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“…4 This review also showed that resistance training reduces motor symptoms quantified by UPDRS-III scores. In this study, the mean changed score after resistance training for on-medication UPDRS-III score of 3.6 exceeds reported minimal clinically important difference (MCID) values of 2.3-2.7, 25 indicating clinically meaningful changes have occurred. In addition, Corcos et al reported a larger mean reduction of 7.2 points in off-medication UPDRS-III scores post progressive resistance training compared to the active controls.…”

Section: Discussionmentioning

confidence: 68%

Effectiveness of resistance training on muscle strength and physical function in people with Parkinson’s disease: a systematic review and meta-analysis

2015

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Objectives: To systematically review the evidence investigating the effectiveness of resistance training on strength and physical function in people with Parkinson's disease. Data sources: Seven electronic databases (COCHRANE, CINAHL, Medline ISI, Psycinfo, Scopus, Web of Science ISI and Embase) were systematically searched for full-text articles published in English between 1946 and November 2014 using relevant search terms. Review methods: Only randomized controlled trials investigating the effects of resistance training on muscle strength and physical function in people with Parkinson's disease were considered. The PEDro scale was used to assess study quality. Studies with similar outcomes were pooled by calculating standardized mean differences (SMD) using fixed or random effects model, depending on study heterogeneity. Results: Seven studies, comprising of 401 participants with early to advanced disease (Hoehn & Yahr stage 1 to 4), were included. The median quality score was 6/10. The meta-analyses demonstrated significant SMD in favour of resistance training compared to non-resistance training or no intervention controls for muscle strength (0.61; 95% CI, 0.35 to 0.87; P <0.001), balance (0.36; 95% CI, 0.08 to 0.64; P = 0.01) and parkinsonian motor symptoms (0.48; 95% CI, 0.21 to 0.75; P < 0.001) but not for gait, balance confidence and quality of life. Conclusion: This review demonstrates that moderate intensity progressive resistance training, 2-3 times per week over 8-10 weeks can result in significant strength, balance and motor symptoms gains in people with early to moderate Parkinson's disease.

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“…The improvement in the motor UPDRS score (mean 5 2.8 points) appears to be meaningful because it exceeded the reported mean minimal clinically important difference of 2.5 (2.3-2.7) points. 36 The lack of significant changes on most cognitive measures could be attributable to the stability of performance on neuropsychological tests over short time spans in PD with no significant cognitive impairment. 37 However, we observed significant improvement on a measure of inhibition in a magnitude similar to that reported in an aerobic exercise study on healthy elderly.…”

Section: Increase In Vȯmentioning

confidence: 99%

Phase I/II randomized trial of aerobic exercise in Parkinson disease in a community setting

et al. 2014

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Objectives: To (1) investigate effects of aerobic walking on motor function, cognition, and quality of life in Parkinson disease (PD), and (2) compare safety, tolerability, and fitness benefits of different forms of exercise intervention: continuous/moderate intensity vs interval/alternating between low and vigorous intensity, and individual/neighborhood vs group/facility setting. Methods:Initial design was a 6-month, 2 3 2 randomized trial of different exercise regimens in independently ambulatory patients with PD. All arms were required to exercise 3 times per week, 45 minutes per session.Results: Randomization to group/facility setting was not feasible because of logistical factors.Over the first 2 years, we randomized 43 participants to continuous or interval training. Because preliminary analyses suggested higher musculoskeletal adverse events in the interval group and lack of difference between training methods in improving fitness, the next 17 participants were allocated only to continuous training. Eighty-one percent of 60 participants completed the study with a mean attendance of 83.3% (95% confidence interval: 77.5%-89.0%), exercising at 46.8% (44.0%-49.7%) of their heart rate reserve. There were no serious adverse events. Across all completers, we observed improvements in maximum oxygen consumption, gait speed, Unified Parkinson's Disease Rating Scale sections I and III scores (particularly axial functions and rigidity), fatigue, depression, quality of life (e.g., psychological outlook), and flanker task scores (p , 0.05 to p , 0.001). Increase in maximum oxygen consumption correlated with improvements on the flanker task and quality of life (p , 0.05). Conclusions:Our preliminary study suggests that aerobic walking in a community setting is safe, well tolerated, and improves aerobic fitness, motor function, fatigue, mood, executive control, and quality of life in mild to moderate PD. Classification of evidence:This study provides Class IV evidence that in patients with PD, an aerobic exercise program improves aerobic fitness, motor function, fatigue, mood, and cognition. Figure Test; FSS 5 Fatigue Severity Scale; HR max 5 maximal heart rate; HRR 5 heart rate reserve; PD 5 Parkinson disease; PDQUALIF 5 Parkinson's Disease Quality of Life Scale; PIS 5 percent increase score; RT 5 reaction time; UPDRS 5 Unified Parkinson's Disease Rating Scale; Vȯ 2 5 maximum oxygen uptake.

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The Clinically Important Difference on the Unified Parkinson's Disease Rating Scale

Cited by 440 publications

References 40 publications

Are the Effects of Community-Based Dance on Parkinson Disease Severity, Balance, and Functional Mobility Reduced with Time? A 2-Year Prospective Pilot Study

Are the Effects of Community-Based Dance on Parkinson Disease Severity, Balance, and Functional Mobility Reduced with Time? A 2-Year Prospective Pilot Study

Effectiveness of resistance training on muscle strength and physical function in people with Parkinson’s disease: a systematic review and meta-analysis

Phase I/II randomized trial of aerobic exercise in Parkinson disease in a community setting

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