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INTRODUCTION: Both Parkinson's disease (PD) and the process of ageing are associated with functional limitations. The aim of this study was to determine the differences in motor and process skills between individuals with PD and healthy older adults, as well as to observe how disease progression affects motor and process skills performance in PD patients. SUBJECTS AND METHODS: A cross-sectional study was conducted. The Assessment of Motor and Process Skills (AMPS) measure was employed in order to analyze the differences in the motor and process skills of daily tasks in people with PD and healthy older adults age- and sex-matched. Part III of the Unified Parkinson Disease Rating Scale (UPDRS), the Hoehn and Yahr (HY) scale and the Schwab & England scale was administered to determine the severity of the disease. RESULTS: Seventy participants (49 patients with PD and 21 healthy older adults) were recruited for this study. Our results showed that even at moderate stages of the disease, both motor and process skills were found deteriorated in PD patients more than older healthy older adults (p < 0.001). As PD progresses, motor and process skills present significantly deterioration. CONCLUSION: PD leads to a greater deterioration in motor and process skills compared to healthy older adults. As disease stages advance according to the HY scale, performance in motor and process skills deteriorates significantly between moderate and advanced PD stages. According to the AMPS scale, PD patients show no impairment of processing skills up to HY IV, but motor impairment at HY stages II, III and IV.
TITLE: Habilidades motoras y de procesamiento en personas con enfermedad de Parkinson en comparación con adultos mayores sanos. Un estudio transversal.Introducción. Tanto la enfermedad de Parkinson (EP) como el proceso de envejecimiento están asociados con limitaciones funcionales. El objetivo de este estudio fue determinar las diferencias en habilidades motoras y de procesamiento entre individuos con EP y adultos mayores sanos, así como observar cómo la progresión de la enfermedad afecta al desempeño de las habilidades motoras y de procesamiento en pacientes con EP. Sujetos y métodos. Se realizó un estudio transversal. Se empleó la medida de la Assessment of Motor and Process Skills (AMPS) para analizar las diferencias en las habilidades motoras y de procesamiento de tareas cotidianas entre personas con EP y adultos mayores sanos, emparejados en edad y sexo. Se administró la sección III de la Unified Parkinson Disease Rating Scale, la escala de Hoehn y Yahr (HY) y la escala de Schwab & England para determinar la gravedad de la enfermedad. Resultados. Se reclutó a 70 participantes (49 pacientes con EP y 21 adultos mayores sanos). Nuestros resultados mostraron que incluso en estadios moderados de la enfermedad, tanto las habilidades motoras como las de procesamiento se encontraron deterioradas en los pacientes con EP en comparación con los adultos mayores sanos (p < 0,001). A medida que avanza la enfermedad, las habilidades motoras y de procesamiento presentan un deterioro significativo en las personas con EP. Conclusiones. La EP conduce a un mayor deterioro de las habilidades motoras y de procesamiento en comparación con adultos mayores sanos. A medida que avanzan los estadios de la enfermedad según la escala HY, el rendimiento en las habilidades motoras y de procesamiento se deteriora significativamente entre los estadios moderados y avanzados de la EP. Según la escala AMPS, los pacientes con EP no muestran un deterioro en las habilidades de procesamiento hasta el estadio HY IV, pero muestran deterioro motor en los estadios HY II, III y IV.
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Doença de Parkinson , Humanos , Idoso , Estudos Transversais , Nível de Saúde , Progressão da Doença , Índice de Gravidade de DoençaRESUMO
INTRODUCTION: The progression of Parkinson's disease (PD) results in a loss of ability to performance activities of daily living and health-related quality of life. The objectives of this study were to establish the relations between occupational performance skills and health-related quality of life, and the degree of caregiver burden in PD patients. PATIENTS AND METHODS: Forty-nine patients at different stages of PD according to the Hoehn and Yahr scale participated in the study. Patients were assessed using the Parkinson's Disease Questionnaire (PDQ-39), the EuroQoL (EQ-5D), the Assessment of Motor and Process Skills (AMPS), and the Zarit Caregiver Burden Interview (ZCBI). RESULTS: Strong correlations were found between the motor skills section of the AMPS scale and the PDQ-39 (r = -0.76; p = 0.001), and the EQ-5D questionnaires (r = 0.72; p = 0.001), while moderate correlations were found with the process skills. AMPS process skills were moderately correlated with mobility and activities of daily living. The ZCBI was only weakly correlated with the AMPS motor skills (r = -0.34; p = 0.02). CONCLUSION: Declining scores on the AMPS scale are closely related to the loss of health-related quality of life in PD patients, and, to a lesser extent, with the degree of caregiver burden.
TITLE: Habilidades de desempeño ocupacional en la enfermedad de Parkinson: relación con la calidad de vida relacionada con la salud y la carga del cuidador.Introducción. La progresión de la enfermedad de Parkinson (EP) da lugar a una pérdida de la capacidad para realizar actividades de la vida diaria y de la calidad de vida relacionada con la salud. Los objetivos de este estudio fueron establecer las relaciones entre las habilidades de desempeño ocupacional y la calidad de vida relacionada con la salud, y el grado de carga del cuidador en pacientes con EP. Pacientes y métodos. Participaron en el estudio 49 sujetos en diferentes estadios de EP según la escala de Hoehn y Yahr. Los pacientes fueron evaluados usando el cuestionario de la enfermedad de Parkinson (PDQ-39), el EuroQoL (EQ-5D), la evaluación de las habilidades motoras y de procesamiento (AMPS), y la entrevista de Zarit sobre la carga del cuidador (ZCBI). Resultados. Se encontraron fuertes correlaciones entre la sección de habilidades motoras de la AMPS y el PDQ-39 (r = 0,76; p = 0,001), y los cuestionarios EQ-5D (r = 0,72; p = 0,001), mientras que se encontraron correlaciones moderadas con las habilidades de procesamiento. Las habilidades de procesamiento de la AMPS se correlacionaron moderadamente con la movilidad y las actividades de la vida diaria. La ZCBI sólo se correlacionó débilmente con las habilidades motoras de la AMPS (r = 0,34; p = 0,02). Conclusión. Las puntuaciones decrecientes en la AMPS están estrechamente relacionadas con la pérdida de calidad de vida relacionada con la salud en pacientes con EP y, en menor medida, con el grado de carga del cuidador.
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Doença de Parkinson , Qualidade de Vida , Humanos , Sobrecarga do Cuidador , Atividades Cotidianas , Cuidadores , Inquéritos e QuestionáriosRESUMO
BACKGROUND: Different types of therapies were proven effective for the medical management of motor and non-motor symptoms in Parkinson's disease (PD). We aimed to gain consensus on the dopamine agonist (DA) therapy use in different clinical scenarios of Parkinson's disease (PD) patients. METHODS: This consensus study was based on the nominal group technique. Initially, a consensus group comprising 12 expert neurologists in the PD field identified the topics to be addressed and elaborated different evidence-based preliminary statements. Next, a panel of 48 Spanish neurologists expressed their opinion on an internet-based systematic voting program. Finally, initial ideas were reviewed and rewritten according to panel contribution and were ranked by the consensus group using a Likert-type scale. The analysis of data was carried out by using a combination of both qualitative and quantitative methods. The consensus was achieved if the statement reached ≥ 3.5 points in the voting process. RESULTS: The consensus group produced 76 real-world recommendations. The topics addressed included 12 statements related to DA therapy in early PD, 20 statements concerning DA treatment strategy in patients with motor complications, 11 statements associated with DA drugs and their side effects, and 33 statements regarding DA therapy in specific clinical scenarios. The consensus group did not reach a consensus on 15 statements. CONCLUSION: The findings from this consensus method represent an exploratory step to help clinicians and patients in the appropriate use of DA in different stages and clinical situations of PD.
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INTRODUCTION: Parkinson's disease (PD) is the second most common neurodegenerative disease. However, diagnosing, assessing, and treating these patients is a complex process requiring continuous monitoring. In this context, smartphones may be useful in the management of patients with PD. OBJECTIVE: The purpose of this study is to perform a systematic review of the literature addressing the use of mobile phone applications (apps) in PD. MATERIALS AND METHODS: We conducted a literature search of articles published in English or Spanish between 2011 and 2016 analysing or validating apps specifically designed for or useful in PD. In addition, we searched for apps potentially useful for PD patients in the leading app stores. CONCLUSIONS: The literature and app searches yielded a total of 125 apps, 56 of which were classified as potentially useful in PD and 69 as specifically designed for PD (23 information apps, 29 assessment apps, 13 treatment apps, and 4 assessment and treatment apps). Numerous mobile apps are potentially useful in or specifically designed for PD management. However, scientific evidence of their usefulness is scarce and of poor quality. Further studies are needed to validate these tools and regulate their use.
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Aplicativos Móveis , Doença de Parkinson/terapia , Telefone Celular , Humanos , TelemedicinaRESUMO
We report 27 cases of delayed-onset dystonia in patients with antecendents of perinatal asphyxia after excluding other possible causes of dystonia. The patients were 16 males and 11 females (mean +/- SD age at onset of dystonia = 13.0 +/- 9.4 yr). Adverse obstetric and/or perinatal events were presented by 20 patients, and other neurological symptoms or signs were present prior to dystonia in 15 patients. The pattern of dystonia was: generalized (eight cases), segmental (six), multifocal (three), hemidystonia (two), and focal (eight). Cranial CT or MRI were normal in 21 cases, and showed brain hemiatrophy in three cases, and periventricular demyelination, subcortical atrophy and increased ventricular size in one case each. The possible cause-effect relationship is discussed.
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INTRODUCTION: Paroxysmal movement disorders are of sudden onset, paroxystic or intermittent, with normality or at least absence of abnormal movements between episodes. They are uncommon conditions with high familial incidence. The commonest form is paroxystic dystony. Paroxystic ataxia and paroxystic tremor are much rarer. DEVELOPMENT: Paroxystic dystony is seen clinically as paroxystic episodes of variable duration, consisting of dystonic movements and postures which present spontaneously or are triggered by certain stimuli or situations. There are different types: kinesgenic paroxystic choreoathetosis, dystonic paroxystic choreoathetosis, intermediate paroxystic choreoathetosis and nocturnal paroxystic choreoathetosis. The paroxystic ataxias are characterized by recurrent episodes of ataxia in the absence of any known metabolic defect. In type 1 episodic ataxia there are also episodes of ataxia and myochemical changes. The gene responsible for this condition has been found on the short arm of chromosome 12. Type 2 episodic ataxia is characterized by its excellent response to acetazolamide. The gene responsible is found on the short arm of chromosome 19. CONCLUSION: Very few cases of paroxystic tremor have been described.
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Coreia , Acetazolamida/uso terapêutico , Anticonvulsivantes/uso terapêutico , Coreia/diagnóstico , Coreia/tratamento farmacológico , Coreia/etiologia , Humanos , Fatores de Risco , Índice de Gravidade de DoençaRESUMO
The development of a variety of side effects associated with long term treatment of Parkinson s disease has prompted the introduction of new drugs and new treatment strategies. The use of dopamine agonists in combination with levodopa has proved to be useful in advanced patients with motor fluctuations. Recent studies indicate that the use of dopamine agonists in monotherapy from the early stages of the disease can be as effective as levodopa for clinical improvement with the added advantage of a significant less presentation of diskinesias. Ropinirol the first dopaminergic agonist demonstrating this effect in a 5 year controlled study, has well tolerance, both in combination or in monotherapy. Although low doses can be useful for individual patients, doses of approximately 15 16 mg/day proved to be safe and effective in long term studies.