Influence of functional disability on quality of life in patients with atypical parkinsonism
DOI:
https://doi.org/10.21527/2176-7114.2024.49.14312Keywords:
Parkinsonism, Quality of Life, Gait, Functionality, StrengthAbstract
Objective: To evaluate the level of functional capacity and its association with the quality of life (QoL) in patients with atypical parkinsonism (AP). Methods: This is a cross-sectional study involving a clinical assessment by a physician and a physiotherapist to confirm the diagnosis of AP and complete the clinical analysis; Timed Up and Go (TUG) test, handgrip strength, Parkinson's Disease Quality of Life Questionnaire (PDQ-39), Hoehn & Yahr (H&Y) scale, Frontal Assessment Battery (FAB), and Montreal Cognitive Assessment (MoCA). Results: Twenty-one elderly patients with AP were recruited, with a predominance of males (76%). Functional impairment was observed in 80% of patients with a TUG > 20 seconds, and 57% had dynapenia. Stratifying patients with and without dynapenia, we found that those with dynapenia had worse QoL according to the PDQ-39 questionnaire (p = 0.04). Additionally, a significant negative correlation was found between the dynamometer values of the dominant limb (Kgf) and QoL in patients with AP (R = -0.449 and P = 0.049); a significant positive correlation was observed where the severity of AP assessed by the Hoehn & Yahr scale directly influenced functional capacity as measured by the TUG test (R = 0.580 and P = 0.009), and a significant correlation between MoCA and FAB (R = 0.867 and P = 0.001). These findings were supported by significant results in linear regression, which determined the direct influence of functionality on QoL in these patients. Conclusion: The severity of AP negatively impacts functionality, consequently impairing QoL in patients diagnosed with AP.
References
Jankovic J. Parkinson’s disease: clinical features and diagnosis. J Neurol Neurosurg Psychiatry. 2008;79(4):368-376. doi:10.1136/jnnp.2007.131045
Gibb WR, Lees AJ. The relevance of the Lewy body to the pathogenesis of idiopathic Parkinson’s disease. J Neurol Neurosurg Psychiatry. 1988;51(6):745-752. doi:10.1136/jnnp.51.6.745
Vertes AC, Beato MR, Sonne J, Khan Suheb MZ. Parkinson-Plus Syndrome.; 2023.
Raccagni C, Nonnekes J, Bloem BR, et al. Gait and postural disorders in parkinsonism: a clinical approach. J Neurol. 2020;267(11):3169-3176. doi:10.1007/s00415-019-09382-1
Simonsen EB. Contributions to the understanding of gait control. Dan Med J. 2014;61(4):B4823.
Nightingale CJ, Mitchell SN, Butterfield SA. Validation of the Timed Up and Go Test for Assessing Balance Variables in Adults Aged 65 and Older. J Aging Phys Act. 2019;27(2):230-233. doi:10.1123/japa.2018-0049
Katsarou Z, Bostantjopoulou S, Peto V, Alevriadou A, Kiosseoglou G. Quality of life in Parkinson’s disease: Greek translation and validation of the Parkinson’s disease questionnaire (PDQ-39). Quality of Life Research. 2001;10(2):159-163. doi:10.1023/A:1016720400862
Jin X, Wang L, Liu S, Zhu L, Loprinzi PD, Fan X. The Impact of Mind-Body Exercises on Motor Function, Depressive Symptoms, and Quality of Life in Parkinson’s Disease: A Systematic Review and Meta-Analysis. Int J Environ Res Public Health. 2019;17(1):31. doi:10.3390/ijerph17010031
Gilman S, Wenning GK, Low PA, et al. Second consensus statement on the diagnosis of multiple system atrophy. Neurology. 2008;71(9):670-676. doi:10.1212/01.wnl.0000324625.00404.15
Höglinger GU, Respondek G, Stamelou M, et al. Clinical diagnosis of progressive supranuclear palsy: The movement disorder society criteria. Movement Disorders. 2017;32(6):853-864. doi:10.1002/mds.26987
Armstrong MJ, Litvan I, Lang AE, et al. Criteria for the diagnosis of corticobasal degeneration. Neurology. 2013;80(5):496-503. doi:10.1212/WNL.0b013e31827f0fd1
McKeith IG, Boeve BF, Dickson DW, et al. Diagnosis and management of dementia with Lewy bodies. Neurology. 2017;89(1):88-100. doi:10.1212/WNL.0000000000004058
Martinez BP, Lopes WB, Alves GA de A, Júnior LAF, Camelier FWR, Camelier AA. Associação do desempenho físico no teste Timed Up and Go com autorrelato de quedas em idosos hospitalizados. Revista Pesquisa em Fisioterapia. 2019;9(2):159-165. doi:10.17267/2238-2704rpf.v9i2.2252
Morris M, Osborne D, Hill K, et al. Predisposing factors for occasional and multiple falls in older Australians who live at home. Australian Journal of Physiotherapy. 2004;50(3):153-159. doi:10.1016/S0004-9514(14)60153-7
Desrosiers J, Bravo G, Hébert R, Dutil É. Normative Data for Grip Strength of Elderly Men and Women. The American Journal of Occupational Therapy. 1995;49(7):637-644. doi:10.5014/ajot.49.7.637
Mansour KMK, Goulart C da L, Carvalho-Junior LCS de, Trimer R, Borghi-Silva A, Silva ALG da. Pontos de corte da função pulmonar e capacidade funcional determinantes para sarcopenia e dinapenia em pacientes com DPOC. Jornal Brasileiro de Pneumologia. 2019;45(6). doi:10.1590/1806-3713/e20180252
Lauretani F, Russo CR, Bandinelli S, et al. Age-associated changes in skeletal muscles and their effect on mobility: an operational diagnosis of sarcopenia. J Appl Physiol. 2003;95(5):1851-1860. doi:10.1152/japplphysiol.00246.2003
Souza RG, Borges V, Silva SMC de A, Ferraz HB. Quality of life scale in parkinson’s disease PDQ-39 - (Brazilian Portuguese version) to assess patients with and without levodopa motor fluctuation. Arq Neuropsiquiatr. 2007;65(3b):787-791. doi:10.1590/S0004-282X2007000500010
Hoehn MM, Yahr MD. Parkinsonism: onset, progression, and mortality. Neurology. 1967;17(5):427-427. doi:10.1212/WNL.17.5.427
Slachevsky A, Villalpando JM, Sarazin M, Hahn-Barma V, Pillon B, Dubois B. Frontal Assessment Battery and Differential Diagnosis of Frontotemporal Dementia and Alzheimer Disease. Arch Neurol. 2004;61(7). doi:10.1001/archneur.61.7.1104
Nasreddine ZS, Phillips NA, Bédirian V, et al. The Montreal Cognitive Assessment, MoCA: A Brief Screening Tool For Mild Cognitive Impairment. J Am Geriatr Soc. 2005;53(4):695-699. doi:10.1111/j.1532-5415.2005.53221.x
Freitas S, SMR, MC, VM, & SI. Estudos de adaptação do Montreal Cognitive Assessment (MoCA) para a população portuguesa. Avaliaçao Psicologica: Interamerican Journal of Psychological Assessment. 2010;9(3):345-357.
Ozer FF, Akın S, Gultekin M, Zararsız GE. Sarcopenia, dynapenia, and body composition in Parkinson’s disease: are they good predictors of disability?: a case–control study. Neurological Sciences. 2020;41(2):313-320. doi:10.1007/s10072-019-04073-1
Correa TV, da Silva Rocha Paz T, Allodi S, de Britto VLS, Correa CL. Progressive muscle-strength protocol for the functionality of upper limbs and quality of life in individuals with Parkinson’s disease: Pilot study. Complement Ther Med. 2020;52:102432. doi:10.1016/j.ctim.2020.102432
Woo J. Sarcopenia. Clin Geriatr Med. 2017;33(3):305-314. doi:10.1016/j.cger.2017.02.003
Lana R, Álvares L, Nasciutti-Prudente C, Goulart F, Teixeira-Salmela L, Cardoso F. Percepção da qualidade de vida de indivíduos com doença de parkinson através do PDQ-39. Revista Brasileira de Fisioterapia. 2007;11(5). doi:10.1590/S1413-35552007000500011
Zhao N, Yang Y, Zhang L, et al. Quality of life in Parkinson’s disease: A systematic review and meta‐analysis of comparative studies. CNS Neurosci Ther. 2021;27(3):270-279. doi:10.1111/cns.13549
Zhou Z, Zhou R, Wei W, Luan R, Li K. Effects of music-based movement therapy on motor function, balance, gait, mental health, and quality of life for patients with Parkinson’s disease: A systematic review and meta-analysis. Clin Rehabil. 2021;35(7):937-951. doi:10.1177/0269215521990526
Yoo JE, Jang W, Shin DW, et al. Timed Up and Go Test and the Risk of Parkinson’s Disease: A Nation‐wide Retrospective Cohort Study. Movement Disorders. 2020;35(7):1263-1267. doi:10.1002/mds.28055
Morris S, Morris ME, Iansek R. Reliability of Measurements Obtained With the Timed “Up & Go” Test in People With Parkinson Disease. Phys Ther. 2001;81(2):810-818. doi:10.1093/ptj/81.2.810
Kahn L, Mathkour M, Lee SX, et al. Long-term outcomes of deep brain stimulation in severe Parkinson’s disease utilizing UPDRS III and modified Hoehn and Yahr as a severity scale. Clin Neurol Neurosurg. 2019;179:67-73. doi:10.1016/j.clineuro.2019.02.018
Osborne RA, Sekhon R, Johnston W, Kalra S. Screening for frontal lobe and general cognitive impairment in patients with amyotrophic lateral sclerosis. J Neurol Sci. 2014;336(1-2):191-196. doi:10.1016/j.jns.2013.10.038
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