ABSTRACT
Background: Handicap is a patient-centered measure of health status that encompasses the impact of social and physical environment on daily living, having been assessed in advanced and late-stage Parkinson's Disease (PD). Objective: To characterize the handicap of a broader sample of patients. Methods: A cross-sectional study of 405 PD patients during the MDS-UPDRS Portuguese validation study, using the MDS-UPDRS, Unified Dyskinesias Rating Scale, Nonmotor symptoms questionnaire, PDQ-8 and EQ-5D-3L. Handicap was measured using the London Handicap Scale (LHS). Results: Mean age was 64.42 (±10.3) years, mean disease duration 11.30 (±6.5) years and median HY 2 (IQR, 2-3). Mean LHS was 0.652 (±0.204); "Mobility," "Occupation" and "Physical Independence" were the most affected domains. LHS was significantly worse in patients with longer disease duration, older age and increased disability. In contrast, PDQ-8 did not differentiate age groups. Handicap was significantly correlated with disease duration (r = -0.35), nonmotor experiences of daily living (EDL) (MDS-UPDRS-I) (r = -0.51), motor EDL (MDS-UPDRS-II) (r = -0.69), motor disability (MDS-UPDRS-III) (r = -0.49), axial signs of MDS-UPDRS-III (r = -0.55), HY (r = -0.44), presence of nonmotor symptoms (r = -0.51) and PDQ-8 index (r = -0.64) (all P < 0.05). Motor EDL, MDS-UPDRS-III and PDQ-8 independently predicted Handicap (adjusted R 2 = 0.582; P = 0.007). Conclusions: The LHS was easily completed by patients and caregivers. Patients were mild-moderately handicapped, which was strongly determined by motor disability and its impact on EDL, and poor QoL. Despite correlated, handicap and QoL seem to differ in what they measure, and handicap may have an added value to QoL. Handicap seems to be a good measure of perceived-health status in a broad sample of PD.
ABSTRACT
Background: Physiotherapists have an ethical, professional, and regulatory responsibility for safety in all aspects of patient care. Notwithstanding, the adverse events issue has been inadequately addressed in the rehabilitation research field. Objectives: To determine the frequency and characterize the adverse events that occur during or in between physiotherapy sessions for parkinsonian syndromes. Methods: An exploratory clinical study was conducted. Physiotherapists were asked to actively report the adverse events that occurred during or between sessions for parkinsonian syndromes. Results: A total of 100 patients were enrolled in the study, which resulted in 1845 sessions. The most common adverse events reported were falls, pain/discomfort, and hypotension, with a total of 128 adverse events reported. Conclusions: During the physiotherapy sessions, adverse events do occur. Future research should clarify the relationship between AE occurrence and the type of intervention as well as causality and risk-minimization strategies.
ABSTRACT
BACKGROUND: A recent survey reported a high risk of drowning in Parkinson's disease (PD) patients. This study intended to assess PD patients' swimming ability and explore the disease-related characteristics that may affect this. METHODS: A cross-sectional study was conducted in idiopathic PD patients. The assessment included swimming in 2 different styles and the evaluation of isolated technical gestures. The primary outcome was the frequency of patients who were able to swim. Limb coordination, blockage episodes, and capacity to maintain the body in a horizontal position were also evaluated. RESULTS: Thirteen patients were evaluated. Three patients were able to swim according to the predefined definition. The inability to maintain the horizontal position and floatability were the main reasons identified for the decrease in swimming performance. CONCLUSIONS: Swimming ability is compromised in some PD patients. Further studies are needed to evaluate the global frequency of swimming difficulties in PD patients and their contributing factors. © 2019 International Parkinson and Movement Disorder Society.
