Reliability, Concurrent Validity, Responsiveness and Measurement Error of the Portuguese Version of Comprehensive Motor Coordination Scale in Individuals With Parkinson's Disease.

Abstract

Assessment of motor coordination in patients with Parkinson's disease (PD) is based on motor performance and does not consider movement quality. To validate the Comprehensive Coordination Scale (CCS) in patients with PD and correlate it with motor impairment. This cross-sectional and case-control study included 15 individuals with PD and 15 healthy older individuals as controls. Motor impairments were measured using the MDS-UPDRS (Part III). Motor coordination (CCS) was evaluated by five examiners and classified into four domains: upper and lower limbs and unilateral and bilateral tasks. CCS scores were compared between the groups using the Mann-Whitney test; concurrent validity was evaluated using Spearman's correlation between CCS and PD scales; and the inter-rate reliability was calculated by intraclass correlation coefficient (ICC). There was significant difference between the groups in the upper limb (p<0.001), lower limb (p=0.006), unilateral (p<0.001), bilateral (p=0.015), and total (p<0.001) CCS scores. Total CCS score (ICC 0.78), upper limb (ICC 0.71), lower limb (ICC 0.86) and unilateral (ICC 0.74) showed high inter-rate reliability. Bilateral domain (ICC 0.92) showed very high inter-rate reliability. And, there was negative correlation between CCS upper limb and postural tremor of hands (r=-0.716; p=0.008), unilateral CCS domain with postural tremor of hands (r=-0.687; p=0.012), and CCS total score with postural tremor of hands (r=-0.804; p=0.002). There was high inter-rater agreement for all CCS items, mainly in the lower limb and bilateral tasks. And, there was a moderate-to-very strong correlation between the total and sub-items of the CCS and motor impairment.