Physical assessment as a predictor of mortality in people with Parkinson's disease: A study over 7 years

Abstract

The primary aim of this study was to ascertain whether a battery of physical function measures in a Parkinson's disease (PD) patient cohort predicted mortality status at 7-year follow-up. Secondary aims were establishing which specific tests were the most useful, and whether PD phenotype was a predictor. A retrospective correlation design was used in this study. A cohort of 109 PD patients underwent baseline physiotherapy assessment of gait, balance, posture, muscle strength, and ability to change postural set. We compared mortality status at 7-year follow-up and baseline physical assessment tests. Tinetti gait and balance scores, UPDRS score, 10-m walk test (time, velocity, and number of strides), posture in standing, lying to sitting, sitting to standing, getting up from floor assessments, and time to ascend and descend four steps were found to be statistically significant physical predictors of mortality at 7-year follow-up. In addition, age, sex, and mini-mental state examination were significant nonphysical predictors of mortality. Using Cox regression, a survival model was constructed with age, sex, and Tinetti gait score as independent predictors of mortality. The results of this study suggest that there is a link between reduced physical function and an increased mortality risk in PD populations.

Promoting Exercise in Parkinson’s Disease Through community-based Participatory Research

“…A rich vein of evidence now suggests that exercise or physiotherapy have positive effects on PD function including physiologic capacity, gait, balance, range of motion, muscle strength, cognition and quality of life [6–10]. Gait and balance impairment, the cardinal motor features of PD that generally become more prominent with disease severity, are associated with increased mortality [11,12]. Recently, the American Academy of Neurology Quality Standards Subcommittee noted that “exercise may be helpful in improving motor function in people with PD” [13].…”

Parkinson's disease severity and motor subtype influence physical capacity components

“…However, these studies failed to consider some patient characteristics which are decisive to motor performance such as age, age at the onset of disease or even UPRDS score. The subgroups in these studies were not similar in these characteristics (Alves et al, 2006;Gray et al, 2009). Thus, our study presents a different approach: when evaluating all groups with the same anthropometric and clinical characteristics (with the obvious differences between HY and UPRDS scores for different disease stages) we assure that these features are not responsible for our results.…”

“…Some studies have compared the rate of disease progression and motor impairments in both motor subgroups, showing that AR presents a stepper clinical advance than TD (Alves et al, 2006;Gray et al, 2009; Jankovic & Kapadia, 2001). However, these studies failed to consider some patient characteristics which are decisive to motor performance such as age, age at the onset of disease or even UPRDS score.…”

Effects of Alexander-Based Corrective Techniques on Forward Flexed Posture, Risk of Fall, and Fear of Falling in Idiopathic Parkinson’s Disease

“…The physical and social aspects of posture disorders, along with gait and balance attributes, are determining factors for the risk of fall (21,22). ABCT, as a complement therapy for musculoskeletal disorders of PD patients, was first hypothesized in 1997 by Stallibrass for neuromuscular rehabilitation (19).…”