Association between executive and physical functions in people with Parkinson's disease.

PURPOSE: People with Parkinson's disease (PD) can develop cognitive and physical impairments. There is limited evidence on the association between executive function and physical function in people with PD. OBJECTIVE: We aimed to investigate the association between the executive and physical functions in people with Parkinson's disease (PD) by comparing healthy controls. METHOD: Thirty-three patients diagnosed with PD and 33 healthy controls were included in the study. PD group was divided into two subgroups according to their scores on executive tests as high performers (PD-HPs; n = 17) and low performers (PD-LPs; n = 16). The severity of motor symptoms disease severity, executive function, global cognitive function, reaction time, hand function, functional capacity, physical activity, and balance confidence was assessed by the validated instruments. RESULTS: The PD group had less physical function and executive function compared to healthy controls (p < 0.05). The PD-LPs group had less physical and cognitive function than the PD-HPs group (p < 0.05). The executive functions were significantly correlated with almost all variables in both people with PD and healthy people, and correlations were moderate to strong (p < 0.05). However, the correlation coefficients were relatively higher in people with PD compared to healthy controls. CONCLUSION: There was a significant association between executive and physical function in people with PD. Future studies should be conducted to determine whether the treatment of one of these dysfunctions affects the other.

Structural and Functional Changes in Mild Cognitive Impairment in Parkinson's Disease.

Background and Objectives: The pathophysiology of mild cognitive impairment in Parkinson's disease (PD-MCI) is still not fully elucidated. It has been shown in a few studies in the literature that volume loss in the occipital, parietal and frontal cortices and atrophy in the hippocampus of PD-MCI patients can occur in the early stages of PD. The aim of this study was to evaluate the relationship between gray and white matter volumes and different neuropsychological tests and volumetric magnetic resonance imaging parameters in patients with mild cognitive impairment in Parkinson's disease (PD-MCI). Materials and Methods: Twenty-six PD-MCI and twenty-six healthy elderly (HC) were included in this study. Results: We found that Mini Mental State Examination, Trail Making Test Part A, Clock Drawing Test, Benton Line Judgment Orientation Test and pentagon figure-copying scores were impaired in PD-MCI patients due to the decrease in brain volumes. Conclusions: Our study revealed that among PD-MCI patients, there was a more noticeable decline in White matter volume (WMV) based on volumetric Magnetic Resonance Imaging (MRI) compared to the localized loss of GMV. We think that these abnormal neuropsychological tests in PD-MCI patients can be used as pretests in the evaluation of the stage of transition to dementia.

The effects of Pilates training on abdominal muscle thickness and core endurance in patients with Parkinson's disease: a single-blind controlled clinical study.

BACKGROUND: This study aims at examining the effects of Pilates training on the transversus abdominis (TrA) and internal obliques (IO) muscle thickness and core endurance in different positions in patients with Parkinson's Disease. METHODS: Patients were divided into 2 groups as Pilates training (n = 13) and control (n = 10) groups. Pilates training was performed twice a week for 6 weeks. The participants' muscle thickness and core endurance were measured at the beginning of the study (pretraining), and the effectiveness of Pilates training was then assessed in the 6th week (posttraining) and in the 12th-week follow-up. The thickness of the TrA and IO muscles was measured with a two-dimensional ultrasonography device. Core endurance was assessed with prone bridge and sit-ups tests. RESULTS: The assessments of the Pilates training group after the 6-week showed a statistically significant increase in the prone bridge and sit-ups test performances, and an increase in the thickness of the IO muscle [during resting in the supine position and abdominal drawing-in maneuver (ADIM) in standing position] and the TrA muscle (during ADIM in the standing position) (p < 0.05). Pilates exercises were also shown to have improved core muscle endurance and thickness (IO thickness during ADIM in the standing position and TrA thickness during resting in the supine position, ADIM in the supine and standing position) in the Pilates training group after a period of 18 weeks (p < 0.05). DISCUSSION: Pilates training has a favorable effect on the core endurance, and the TrA and IO muscle thickness of patients with Parkinson's disease and this effect can be maintained until three months after the training.

Reduced power and phase-locking values were accompanied by thalamus, putamen, and hippocampus atrophy in Parkinson's disease with mild cognitive impairment: an event-related oscillation study.

Parkinson's disease (PD) is a multifaceted neurodegenerative disorder accompanied by mild cognitive impairment (MCI) as a crucial nonmotor manifestation. Event-related oscillations (EROs) are suggested to reflect cognitive status associated with subcortical structures in neurodegenerative conditions. In this study, 36 individuals with PD-MCI and 32 PD-CN were compared with 60 healthy control (HC) participants using visual EROs by measures of event-related spectral perturbation and inter-trial coherence, along with subcortical gray matter volumes based on the FIRST algorithm. Cross-correlations among electrophysiological, neuropsychological, and structural parameters were investigated exploratively. Both PD-MCI and PD-CN patients had diminished delta and alpha phase-locking than HC, however, electrophysiological abnormalities were more pronounced in PD-MCI over frontal, central, parietal, and temporal locations in almost all frequency bands, accompanied by bilateral thalamus, hippocampus, and right putamen atrophy. PD-CN had lower hippocampal volumes than HC, without exhibiting any subcortical differences from PD-MCI. Lastly, EROs showed low-to-high correlations with structural and neuropsychological measures. These findings may highlight the complex interplay between electrophysiological, neuropsychological, and structural parameters in detected abnormalities of PD-CN and PD-MCI.

Effects of Pilates and Elastic Taping on Balance and Postural Control in Early Stage Parkinson's Disease Patients: A Pilot Randomised Controlled Trial.

INTRODUCTION: The purpose of this study is to investigate the effects of Pilates training and elastic taping on balance and postural control in patients with early stage Parkinson's Disease (PD). METHOD: Patients were randomly divided into Pilates, elastic taping, and control (wait list) groups. Pilates training was performed for 6 weeks, twice a week and 60 minutes per session. In elastic taping group, in addition to Pilates training, elastic taping was applied to the upper back twice a week for 6 weeks with the aim of postural correction. In order to evaluate the postural control before and after the training, Berg Balance Scale, Trunk Impairment Scale, the tests of NeuroCom Balance Master performance test device as Limits of stability (LOS), Sit-to Stand, Walk Across and Tandem Walking Tests were performed. RESULTS: The data of 20 patients (6 male in Pilates group, 2 female and 6 male in elastic taping group, 3 female and 3 male in control group) were analyzed. Reaction times in LOS test decreased significantly and walking speed in Walk Across test increased significantly after 6 weeks in Pilates and elastic taping groups. In elastic taping group, the postural sways of Tandem Walk test were decreased significantly and, the rising index in Sit-to-Stand test increased significantly after 6 weeks (Wilcoxon Test, p<0.05). CONCLUSION: We believe that Pilates is a feasible rehabilitation strategy for PD, and it has a remedial effect on the dynamic balance and postural control for these patients. We also think that elastic taping could be applied for supporting the right posture.

A comparison of the relationship between manual dexterity and postural control in young and older individuals with Parkinson's disease.

The motor symptoms of Parkinson's disease (PD) cause deterioration in manual dexterity. This deterioration affects independence in activities of daily living negatively. The loss of postural control, which occurs more frequently with disease progression, restricts physical functions and reduces mobility in patients with PD. Impaired postural control may affect distal mobility of an individual. The aim of this study was to investigate postural control and manual dexterity in individuals ≤ 65 and >65 years with PD and analyze the relationship between these variables according to age. Sixty-six individuals with PD participated in the study. The participants were categorized according to age (n = 29 for 65 years of age or younger and n = 37 for older). Manual dexterity (Dominant and Non-dominant hand) was assessed by the Nine Hole Peg Test (NHPT). Postural control was evaluated by the Limit of Stability Test (LoS) using a computerized balance measuring instrument. There was no statistically significant difference between the age groups on the combined dependent variables after controlling for disability, gender, weight, and height; F(7, 54) = 0.804, p = 0.587. Only LoS-Maximum Excursion was higher in the individuals ≤ 65 years (p = 0.035). Significant correlations were found between NHPT-Dominant and LoS-Reaction Time, LoS-Maximum Excursion; NHPT-Non-dominant and LoS-Reaction Time, LoS-Endpoint Excursion, LoS-Maximum Excursion in the older group (p < 0.05). There was no difference manual dexterity and postural control according to age except for LoS-Maximum Excursion. LoS-Maximum Excursion was higher in the young group. The manual dexterity was associated with postural control in individuals over 65 years of age with PD; however, not associated in younger individuals.

Turkish adaptation of Parkinson fatigue scale and investigating its psychometric properties.

Parkinson's disease (PD) is one of the most common chronic degenerative diseases of the nervous system. In PD, nonmotor symptoms are seen as frequently as motor symptoms. Fatigue can occur in all stages of PD and leads to significant disabilities. The aim of this study was to investigate the psychometric properties of the Turkish version of Parkinson fatigue scale (PFS). Ninety-six patients with idiopathic PD were included in this study with a cross-sectional and test-retest design. Structural validity, internal consistency and test-retest reliability of PFS were analyzed. For convergent validity, fatigue severity scale and modified fatigue impact scale were used. Internal consistency was determined by the Cronbach's α coefficient. For test-retest reliability, PFS was repeated after a 7-14-day period. Significant strong correlations were found between the PFS and the fatigue severity scale (rs=0.844) and the modified fatigue impact scale (rs=0.764), which indicate a high convergent validity. The Cronbach's α coefficient, which indicates the internal consistency of the scale, was calculated as 0.947. The test-retest reliability was found to be high (intraclass correlation coefficient=0.928). This study suggests that the Turkish version of PFS is valid and reliable. PFS is suitable for use by researchers and healthcare professionals to assess fatigue in Turkish-speaking patients with PD.

Reliability, validity and responsiveness of the squares test for manual dexterity in people with Parkinson's disease.

OBJECTIVE: Impaired manual dexterity is one of the major disorder in people with Parkinson's Disease (PwPD). However, there is limited research examining the measurement properties, especially the validity and responsiveness of the tools used to assess manual dexterity. The aim of this study was to examine reliability, validity, and responsiveness of the Squares Test (ST) in PwPD. PATIENTS AND METHODS: Fifty-seven PwPD and 50 healthy people, all of whom were right-handed, were recruited. The ST, Nine-Hole Peg Test, Unified Parkinson's Disease Rating Scale (UPDRS), and Hoehn and Yahr scale were performed in ON state. For responsiveness analysis, the ST and UPDRS motor score (UPDRS-III) were also performed in OFF state. RESULTS: The ST showed excellent test-retest reliability. The ST was found to correlate significantly with other outcome measures, which indicated good concurrent validity. PwPD demonstrated significantly lower scores of the ST than healthy people, which demonstrated satisfactory known-groups validity. The ST had excellent discriminant validity. The ST scores of 52 for more affected hand and 62 for less affected hand were shown to best discriminate between PwPD and healthy people. The ST is high internal responsiveness based on standardized effect size and standardized response mean (0.79 and 1.88, respectively for more affected hand and 0.85 and 1.83, respectively for less affected hand), and also PwPD had better performance based on the ST in ON state than in OFF state (p < 0.001 for both hands). Moderate correlations were found between the change scores of the ST and UPDRS-III, which reflected adequate external responsiveness. CONCLUSIONS: The ST is a reliable, valid and responsive measurement tool for assessing manual dexterity in PwPD.

Validity and Reliability of the Turkish Version of the 8-Item Parkinson's Disease Questionnaire.

INTRODUCTION: Symptomatic control and improvement of health-related quality of life (HRQoL) is a key feature of the management of patients with Parkinson's disease (PD). The 39-item Parkinson's Disease Questionnaire (PDQ) and its short version, PDQ-8, validated disease-specific patient-reported instruments, have been highly recommended to use for assessing HRQoL in patients with PD. The aim of this study was to assess the reliability and validity of the Turkish version of the PDQ-8. METHODS: Eighty-three patients with PD were recruited for this methodological and cross-sectional study. The PDQ-8 was repeated to assess the test-retest reliability after one-week interval. The participants completed the 36-Item Short Form Health Survey (SF-36) as a generic HRQoL previously validated in Turkey. The Hoehn & Yahr stages of the patients were also determined. The SF-36 and Hoehn & Yahr stages were used to assess the convergent validity of the PDQ-8. RESULTS: The Cronbach's alpha coefficient was 0.78 (95% CI: 0.70-0.84, p<0.001) for PDQ-8. The test-retest reliability was very high as the intra-class correlation coefficient was 0.97 (95% CI: 0.93-0.99, p<0.001). The PDQ-8 had significant correlations with the physical and mental component scores of SF-36 (ρ=-0.52, p<0.001 and ρ=-0.64, p<0.001, respectively) and Hoehn & Yahr stages (ρ=0.56, p<0.001). There was no evidence of floor or ceiling effects. CONCLUSION: The results of this study suggest that the Turkish version of the PDQ-8 is a reliable, valid, less time-consuming, and brief disease-specific instrument to assess HRQoL in patients with Parkinson's disease.