File
Dias CPD1, Yuki P1,2, Miranda CDS1, Okamoto E2, Guelfi ET2, d'Alencar M3, Pimentel Piemonte ME4
1University Hospital of University of Sao Paulo, Physical Therapy, Sao Paulo, Brazil, 2Brazil Parkinson's Association, Physical Therapy, Sao Paulo, Brazil, 3University of Sao Paulo, Sao Paulo, Brazil, 4University of Sao Paulo, Physical Therapy, Sao Paulo, Brazil
Background: Among the symptoms associated to Parkinson's disease, some of them as tremor and bradykinesia can affect the manual function. In fact, Daily living activities as handwriting, cutting food and handling utensils, dressing and hygiene are frequently impaired by manual dysfunction in PD. Then, increasing the manual function should be included among the physiotherapeutic targets. However, there is no a stablished test to evaluate manual function in people with PD. This is a barrier to measure the therapeutic effects of PT intervention for hand function. The Nine Hole Peg Test (9HPT) is a fast, simple and cheap test widely used to assess manual function in several neurological conditions, however it has been little used in PD.
Purpose: The purpose of this study was to verify the power of 9HPT and MS to predict the decrease in daily living activities' independence and in quality of life associated to daily living activities 'performance.
Methods: Participated this study 239 people with PD with 68,19 (SD=10,1) mean age, in 1-5 stages of disease evolution according to Hoehn and Yahr (H&Y) Classification, 6.06 (SD=4.8) years of disease evolution), 38.44 (20.3) mean scores in Unified Parkinson´s disease Rating Scale (UPDRS), using regular dopaminergic medication. All participants were testes in ON period of medication, in an individual session using section II UPDRS and section II of Parkinson's Disease Quality of Life Questionnaire (PDQ-39) to assess the independence in daily living activities, and 9HPT and hand muscle strength using a handheld dynamometer to assess the manual function, performed with both hands.
Results: All participants were able to perform the tests. The results obtained in right and left hands with hand muscle strength tests (R=-.32, p .0001 and R=-.31, p .0001, respectively) and with 9HPT (R=.52, p .0001 and R=.20, p .01, respectively) were correlated with severity of motor symptoms, assessed by UPDRS - section III, and disease evolution, assessed by H&Y classification (R>.4, p .001) and not correlated with age, gender and disease duration. However, the multiple regression model showed that only the 9HPT performed with right hand was able to predict the scores in UPDRS- section II (R= .47; R²= .22; Adjusted R²= .21; F(1,195)=56.241 p .00001) and PDQL 39-section II (R= .30 R²= .09; Adjusted R²= .09; F(1.191)=20.21; p .00001). The analysis observed and predict values confirms the power of model for predictions.
Conclusion(s): Although both tests had been correlated with severity of motor symptoms and disease evolution, only the 9HPT performed with dominant hand (right hand) was able to predict the level of independence in DLA and its impact this decline in quality of life in people living with PD.
Implications: The 9HPT is a cheap, easy and fast test which can be useful to assess the manual function in PD and should be incorporated in the physiotherapy clinical practice in PD.
Keywords: Independence in ADL, Hand Function, Evalaution
Funding acknowledgements: Research, Innovation and Dissemination Center for Neuromathematics (NeuroMat), funded by the São Paulo Research Foundation-FAPESP (grant 2013/07699-0)
Purpose: The purpose of this study was to verify the power of 9HPT and MS to predict the decrease in daily living activities' independence and in quality of life associated to daily living activities 'performance.
Methods: Participated this study 239 people with PD with 68,19 (SD=10,1) mean age, in 1-5 stages of disease evolution according to Hoehn and Yahr (H&Y) Classification, 6.06 (SD=4.8) years of disease evolution), 38.44 (20.3) mean scores in Unified Parkinson´s disease Rating Scale (UPDRS), using regular dopaminergic medication. All participants were testes in ON period of medication, in an individual session using section II UPDRS and section II of Parkinson's Disease Quality of Life Questionnaire (PDQ-39) to assess the independence in daily living activities, and 9HPT and hand muscle strength using a handheld dynamometer to assess the manual function, performed with both hands.
Results: All participants were able to perform the tests. The results obtained in right and left hands with hand muscle strength tests (R=-.32, p .0001 and R=-.31, p .0001, respectively) and with 9HPT (R=.52, p .0001 and R=.20, p .01, respectively) were correlated with severity of motor symptoms, assessed by UPDRS - section III, and disease evolution, assessed by H&Y classification (R>.4, p .001) and not correlated with age, gender and disease duration. However, the multiple regression model showed that only the 9HPT performed with right hand was able to predict the scores in UPDRS- section II (R= .47; R²= .22; Adjusted R²= .21; F(1,195)=56.241 p .00001) and PDQL 39-section II (R= .30 R²= .09; Adjusted R²= .09; F(1.191)=20.21; p .00001). The analysis observed and predict values confirms the power of model for predictions.
Conclusion(s): Although both tests had been correlated with severity of motor symptoms and disease evolution, only the 9HPT performed with dominant hand (right hand) was able to predict the level of independence in DLA and its impact this decline in quality of life in people living with PD.
Implications: The 9HPT is a cheap, easy and fast test which can be useful to assess the manual function in PD and should be incorporated in the physiotherapy clinical practice in PD.
Keywords: Independence in ADL, Hand Function, Evalaution
Funding acknowledgements: Research, Innovation and Dissemination Center for Neuromathematics (NeuroMat), funded by the São Paulo Research Foundation-FAPESP (grant 2013/07699-0)
Topic: Neurology; Outcome measurement; Disability & rehabilitation
Ethics approval required: Yes
Institution: Faculty of Medicine of University of São Paulo
Ethics committee: Ethical commitee of FMUSP
Ethics number: 99955
All authors, affiliations and abstracts have been published as submitted.
