Hand Function as Predictor of Motor Symptom Severity in Individuals with Parkinson's Disease.

INTRODUCTION: Parkinson's disease (PD) leads to deficits in upper limb strength and manual dexterity and consequently resulting in functional impairment. Handgrip strength is correlated with the motor symptom severity of the disease, but there is a gap in the literature about the influence of freezing in PD patients. OBJECTIVE: The objective is to study the correlation between handgrip strength and motor symptom severity considering the freezing phenomenon and to verify variables that can predict Unified Parkinson's Disease Rating Scale (UPDRS) III. METHODS: This is a multicenter cross-sectional study in PD. 101 patients were divided into 2 groups: freezing of gait (FOG) (n = 51) and nonfreezing (nFOG) (n = 52). Freezing of Gait Questionnaire (FOGQ); UPDRS II and III sections; Hoehn and Yahr (HY) scale; handgrip dynamometry (HD); 9 Hole Peg Test (9-HPT) were assessed. RESULTS: In both groups, HD was correlated to UPDRS III (nFOG: -0.308; FOG: -0.301), UPDRS total (nFOG: -0.379; FOG: -0.368), UPDRS item 23 (nFOG: -0.404; FOG: -0.605), and UPDRS item 24 (nFOG: -0.405; FOG: -0.515). For the correlation to UPDRS II (0.320) and 9-HPT (-0.323), only nFOG group presented significance. For the UPDRS 25 (-0.437), only FOG group presented statistical significance. The UPDRS III can be predicted by 9-HPT, age, and HY in nFOG patients (Adjusted R2 = 0.416). In FOG group, UPDRS III can be predicted by HD, 9-HPT, age, and HY (Adjusted R2 = 0.491). CONCLUSION: Handgrip strength showed to be predictive of motor impairment only in the FOG group. Our results showed clinical profile differences of motor symptoms considering freezers and nonfreezers with PD.

Progressive muscle-strength protocol for the functionality of upper limbs and quality of life in individuals with Parkinson's disease: Pilot study.

The effects of physical-therapy intervention on the motor function of upper limbs and the quality of life in patients with Parkinson's disease (PD) are not fully understood. We evaluated the effects of a progressive muscle-strengthening protocol for upper limbs on the functionality and quality of life. Patients were divided into two groups: Intervention (n = 6) and Control (n = 7). Assessment tools used were: Unified Parkinson's Disease Rating Scale (UPDRS), Parkinson's Disease Questionnaire, Nine-Hole Peg Test (9HPT), Test d'Évaluation des Membres Supérieurs de Personnes Âgées (TEMPA), 10-Repetition Maximum (10-RM) and handgrip dynamometer, which were applied pre- and post-intervention, with follow-up for one month after the last training session. Only, the Intervention group (post-intervention) showed significant statistical differences, with the following outcomes: UPDRS III (p = 0.042); 9HPT, right (p = 0.028) and left side (p = 0.028); TEMPA for total right side (p = 0.028), left side (p = 0.028) and total bilateral tasks (p = 0.028); TEMPA task 2 - open a jar and take a spoonful of coffee (p = 0.028), task 3 - pick up a pitcher and pour water into a glass for right (p = 0.046) and left side (p = 0.028), task 5 - write on an envelope and stick on a stamp (p = 0.028), and task 6 - shuffle and deal playing cards (p = 0.028). We observed significant statistical differences between groups (post-intervention) for TEMPA task 6 (p = 0.032), total right side (p = 0.032), and total bilateral tasks (p = 0.032). An increase in the maximum load in the post-intervention stage, based on the 10-RM test, was observed on the right (p = 0.003) and left (p = 0.007) sides. Our results showed an improvement in upper-limb functionality in PD patients submitted to progressive muscle-strength training, although not in quality of life.

Measurement properties from the Brazilian Portuguese version of the QUIP-RS.

Parkinson's disease (PD) has numerous motor and non-motor symptoms. Among non-motor manifestations impulse control disorders (ICDs) stand out. ICDs include compulsions for gambling, shopping, eating, and sexual behavior, and "related disorders" such as hobbyism, simple motor activities, and dopamine dysregulation syndrome. There is no rating scale translated and adapted transculturally into Brazilian Portuguese language. Therefore, we cross-culturally adapted and investigated the measurement properties of the Brazilian version of the Questionnaire for Impulsive-Compulsive Disorders in Parkinson's Disease-Rating Scale (QUIP-RS). Fifty-three patients participated in the study. Inter-evaluator and test-retest (patient and health professional) reliabilities (intraclass correlation coefficient) were all excellent (0.93, 0.93, and 0.99). The internal consistency was high (α = 0.92). The Minimal detectable change (MDC) value was 5.8 (patient) and 2.3 (health professional) points. There was a floor, but no ceiling, effect. In summary, the Brazilian version of the QUIP-RS has high reliability and content validity.