Which measures of physical function and motor impairment best predict quality of life in Parkinson’s disease?

Abstract

IntroductionOur objective was to compare the relative value of elements of the motor system in predicting the physical mobility domain of health related quality of life in patients with Parkinson’s disease in order to specify targets for intervention. MethodsIn this cross-sectional study, the Parkinson’s disease questionnaire-39 was administered to 263 subjects with Parkinson’s disease to assess health related quality of life. Demographics, motor impairments and physical function were assessed using the Unified Parkinson disease rating scale, 10-m walk test, 6-min walk test, Freezing of gait questionnaire, Timed up & go, functional gait assessment, Berg balance test, functional reach and 9-hole peg test. ResultsThe results revealed that demographic factors accounted for 19.7% of the variance in Parkinson disease questionnaire-39 mobility score. When motor impairments were added to the model, the bradykinesia composite score contributed a significant portion of the variance (R2 change = 0.12, p < 0.001). The tremor and rigidity composite scores did not contribute significantly. The Freezing of gait questionnaire was the strongest predictor (R2 change = 0.23, p < 0.001) of the physical function tests followed by Functional gait assessment (R2 change = 0.06, p < 0.001) and 6-min walk test (R2 change = 0.01, p = 0.01). Collectively, 61% of the variance in Parkinson disease questionnaire-39 mobility score and 41.5% of the Parkinson disease questionnaire-39total score was accounted for. DiscussionThese results suggest greater value of physical function tests, and not tests of motor impairments, in predicting health related quality of life.