Kinematic and Clinical Outcomes to Evaluate the Efficacy of a Multidisciplinary Intervention on Functional Mobility in Parkinson's Disease.

Raquel Bouça-Machado,Joaquim J Ferreira,Diogo Branco,Raquel Fernandes,Daisy Abreu,Gustavo Fonseca,Tiago Guerreiro

doi:10.3389/fneur.2021.637620

Raquel Bouça-Machado, Joaquim J Ferreira + Show 5 more

Open Access

https://doi.org/10.3389/fneur.2021.637620

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Abstract

Introduction: Functional mobility (FM) is a concept that incorporates the capacity of a person to move independently and safely to accomplish tasks. It has been proposed as a Parkinson's disease (PD) functional and global health outcome. In this study, we aimed to identify which kinematic and clinical outcomes changes better predict FM changes when PD patients are submitted to a specialized multidisciplinary program.Methods: PD patients engaged in a pre-defined specialized multidisciplinary program were assessed at admission and discharge. Change from baseline was calculated for all kinematic and clinical outcomes, and Timed Up and Go (TUG) was defined as the primary outcome for FM. A stepwise multivariate linear regression was performed to identify which outcome measures better predict TUG changes.Results: Twenty-four patients were included in the study. The changes in TUG Cognitive test, supervised step length, and free-living (FL) step time asymmetry were identified as the best predictors of TUG changes. The supervised step length and FL step time asymmetry were able to detect a small to moderate effect of the intervention (d values ranging from −0.26 to 0.42).Conclusions: Our results support the use of kinematic outcome measures to evaluate the efficacy of multidisciplinary interventions on PD FM. The TUG Cognitive, step length, and FL step time asymmetry were identified as having the ability to predict TUG changes. More studies are needed to identify the minimal clinically important difference for step length and FL step time asymmetry in response to a multidisciplinary intervention for PD FM.

Highlights

Functional mobility (FM) is a concept that incorporates the capacity of a person to move independently and safely to accomplish tasks
We aimed to identify which kinematic and clinical outcome measures better predict FM changes when Parkinson’s disease (PD) patients are submitted to a specialized multidisciplinary intervention
The objective of this study is to identify the kinematic and clinical outcome measures that better predict FM changes when PD patients are submitted to a specialized multidisciplinary intervention

Summary

Introduction

Functional mobility (FM) is a concept that incorporates the capacity of a person to move independently and safely to accomplish tasks. It has been proposed as a Parkinson’s disease (PD) functional and global health outcome. Functional mobility (FM) in Parkinson’s disease (PD) has been recently described as a person’s physiological ability to move independently and safely in a variety of environments in order to accomplish functional activities or tasks and to participate in activities of daily living at home, at work, and in the community [1, 2]. From the early disease stage, PD patients experience limitations in their FM With disease progression, these limitations are usually a major cause of disability and loss of independence [1]. It is the recommended tool for assessing FM in PD, other clinical tests are used [2, 4, 5]

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