The neurobehavioral cognitive status examination: Accuracy of the ?screen-metric? approach in a clinical sample

American Journal of Physical Medicine &Amp; Rehabilitation

Hou

Collins

et al. 2016

Objective To investigate the relationships between motor symptoms of Parkinson’s disease (PD) and activity limitations in persons with PD. Design/Methods Cross-sectional study of persons with mild to moderate PD (N=90). Associations among axial motor features, limb motor signs, the Physical Activity Scale for Elders (PASE), the ability to perform Activities of Daily Living (ADL) and level of ADL dependency were studied. A composite score of axial motor features included the following UPDRS items: speech, rigidity of the neck, arising from chair, posture, gait and postural stability. A composite score of limb motor signs included the following UPDRS items: tremor at rest of all extremities, action tremor, rigidity of all extremities, finger taps, hand movement, rapid alternating hand movements and foot tapping. Results Axial motor features of PD were significantly correlated with physical inactivity (p<.001), decreased ADL (p<.001) and increase in ADL dependency (p<.001). Limb motor signs significantly correlated with decreased ADL (p<.001) and level of ADL dependency (p=.035), but was not correlated with physical inactivity. After controlling for age, gender, disease duration and comorbidity, axial motor features contributed significantly to physical inactivity, decreased ADL and increase in ADL dependency, whereas the limb motor signs did not. Conclusions Axial motor impairment contributed to physical inactivity and decreased ability to perform ADLs in persons with PD.

Section: Methodsmentioning

confidence: 99%

Contribution of Axial Motor Impairment to Physical Inactivity in Parkinson Disease

American Journal of Physical Medicine &Amp; Rehabilitation

Hou

Collins

et al. 2016

“…Participants were screened for significant cognitive impairment with the Neurobehavioral Cognitive Status Examination (Cognistat) and any subtest score in the severely impaired range resulted in study exclusion. 9 The study was approved by the Institutional Review Board for Human Subject Research for Baylor College of Medicine and Affiliated Hospitals and the University of Texas Medical Branch.…”

Section: Methodsmentioning

confidence: 99%

Determinants of Use of a Walking Device in Persons With Parkinson's Disease

Archives of Physical Medicine and Rehabilitation

Rintala

Graham

et al. 2014

Objective To identify determinants for use of a walking device in persons with Parkinson's disease (PD). Design Cross-sectional study of participants with PD. Setting Laboratory. Participants Eighty-five persons (60 Males) with PD were studied. Their mean age was 69.4 ± 8.9 years. The average time since diagnosis was 7.9 ± 5.3 years. Interventions Not applicable. Main Outcome Measures Age, gender, disease duration, disease severity and motor impairment were recorded. Participants were asked whether they usually used any walking device (e.g., cane or walker) and were categorized as either an “independent walker” or a “device walker.” Clinical balance measures including functional reach, turn duration, 5m Timed-Up-and-Go test (5m-TUG) and Activities-specific Balance Confidence (ABC) scale were investigated for their contribution to the prediction of walking with a device. Results Thirty-one participants (36.5%) reported they usually used a walking device. Classification and regression tree (CART) analysis determined that the 5m-TUG test and the ABC scale were important factors in differentiating participants who used a walking device from those who did not. Critical thresholds included 13 seconds for the 5m-TUG test and a score of 75 for the ABC scale in determining device walking. Using only those two determinants, the CART model correctly classified 81% of patients as either independent or needing a walking device. Conclusion The 5m-TUG test and ABC scale may be useful in clinical assessments of the need for a walking device in persons with PD.

“…11 The Unified Parkinson Disease Rating Scale (UPDRS) 12 and the Hoehn and Yahr Staging Scale (HY) were used to assess disease severity of the subjects.…”

Section: Methodsmentioning

confidence: 99%

Gait variability in Parkinson’s disease: influence of walking speed and dopaminergic treatment

Rintala

Hou

et al. 2011

Neurological Research

Objectives To study the effects of levodopa and walking speed on gait variability in individuals with Parkinson's disease (PD). Methods Thirty-three individuals with PD were studied. Their mean age was 70.61 ± 9.23 yr. The average time since diagnosis was 9.65 ± 5.80 yr years. Gait variability was studied while “OFF” and “ON” dopaminergic medication when the subjects walked at their usual and fastest speeds. Results Variability of step time, double support time, stride length and stride velocity decreased significantly (p = .037; p = .037; p = .022; p = .043, respectively) after dopaminergic treatment. When subjects increased walking speed, the variability of stride length and stride velocity decreased significantly (p = .038 and p = .004, respectively) both while “OFF” and “ON” levodopa. Increasing walking speed did not change the variability of step time and double support time regardless of medication status. Conclusions Levodopa decreased gait variability in persons with PD. Stride length and stride velocity variability appeared to be speed dependent parameters, whereas, the variability of step time and double support time appeared to be speed independent measures. Levodopa had positive effects on gait stability in PD.