Article

Body-worn, inertial sensors can provide many objective measures of
balance and gait. However, the objective measures that best reflect patient
perception of mobility disability and clinician assessment of Parkinson disease
(PD) are unknown.
The purposes of this study were: (1) to determine
which objective measures of balance and gait are most related to patient
perception of mobility disability and disease severity in people with PD and (2)
to examine the effect of levodopa therapy on these correlates. DESIGN: This was
an experimental correlation study. METHODS: One hundred four people with
idiopathic PD performed 3 trials of the Instrumented Stand and Walk Test (ISAW)
in the "on" and "off" medication states. The ISAW consists of quiet standing (30
seconds), gait initiation, straight walking (7 m), and turning (180 degrees ),
yielding 34 objective measures of mobility from body-worn inertial sensors.
Patient perception of mobility disability was assessed with the
Activities-specific Balance Confidence (ABC) scale and the mobility subscale of
the Parkinson's Disease Questionnaire (PDQ-39). Disease severity was assessed
with the Unified Parkinson's Disease Rating Scale, part III (motor UPDRS).
Spearman correlations were used to relate objective measures of mobility to
patient perception and disease severity. RESULTS: Turning speed, gait speed, and
stride length were most highly correlated to severity of disease and patient
perception of mobility disability. The objective measures of mobility in the
off-medication state were more indicative of patient perception of mobility
disability and balance confidence compared with on-medication state measures.
LIMITATIONS: Causation is an inherent problem of correlation studies. CONCLUSION:
Physical therapists should evaluate mobility in people with PD in the
off-medication state because the off-medication state is more related to disease
severity and patient perception of mobility disability than the on-medication
state mobility. Assessment and treatment of mobility in people with PD should
target specific measures (ie, turning, gait speed, and stride length) because
these measures best reflect patients' quality of life and balance confidence.
CI - (c) 2016 American Physical Therapy Association.

Langue : ANGLAIS