Journal ArticleDOI
The evolution of disability in Parkinson disease.
Lisa M. Shulman,Ann L. Gruber-Baldini,Karen E. Anderson,Christopher G. Vaughan,Stephen G. Reich,Paul S. Fishman,William J. Weiner +6 more
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TLDR
The benchmarks of disability in this study provide guidance when counseling patients about prognosis and better understanding of the stages of disability may facilitate the development of novel outcome measures in clinical trials in PD.Abstract:
The objectives of this study are to assess the level of disease severity associated with disability in Parkinson disease (PD) and the sequence of loss of independence in basic and instrumental activities of daily living (ADLs and IADLs). Six hundred eighteen patients with PD were evaluated for disease severity with the Unified PD Rating Scale (UPDRS) and for disability with the Older Americans Resource and Services Disability Subscale (OARS). The association between patient-reported disability on ADLs and IADLs and level of disease severity on the total UPDRS was examined cross-sectionally. Disability, with loss of independent function is reported between total UPDRS scores 30 to 40, and HY stages II to III. Difficulty with daily activities, without loss of independent function is reported earlier, at UPDRS <20 and HY I to II. Difficulty with walking is initially reported, followed by problems with a number of gait-dependent activities including housework, dressing, transferring in and out of bed, and traveling in the community. The transition from HY stage II to III marks a pivotal milestone in PD, when gait and balance impairment results in disability in many gait-dependent activities. The onset of disability in PD can be identified by asking patients about their walking, housework, dressing, and traveling. While individual patients vary in progression, the benchmarks of disability in this study provide guidance when counseling patients about prognosis. Better understanding of the stages of disability may facilitate the development of novel outcome measures in clinical trials in PD.read more
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Journal ArticleDOI
Randomized Clinical Trial of 3 Types of Physical Exercise for Patients With Parkinson Disease
Lisa M. Shulman,Leslie I. Katzel,Frederick M. Ivey,John D. Sorkin,Knachelle Favors,Karen E. Anderson,Barbara A. Smith,Stephen G. Reich,William J. Weiner,Richard F. Macko +9 more
TL;DR: The lower-intensity treadmill exercise resulted in the greatest improvement in gait speed and cardiovascular fitness, and the combination of treadmill and resistance exercises may result in greater benefit and requires further investigation.
Journal ArticleDOI
Effect of High-Intensity Treadmill Exercise on Motor Symptoms in Patients With De Novo Parkinson Disease: A Phase 2 Randomized Clinical Trial.
Margaret Schenkman,Charity G. Moore,Wendy M. Kohrt,Wendy M. Kohrt,Deborah A. Hall,Anthony Delitto,Cynthia L. Comella,Deborah A. Josbeno,Cory L. Christiansen,Cory L. Christiansen,Brian Berman,Benzi M. Kluger,Edward L. Melanson,Edward L. Melanson,Samay Jain,Julie A. Robichaud,Cynthia Poon,Daniel M. Corcos +17 more
TL;DR: High-intensity treadmill exercise may be feasible and prescribed safely for patients with Parkinson disease and an efficacy trial is warranted to determine whether high- intensity treadmill exercise produces meaningful clinical benefits in de novo Parkinson disease.
Journal ArticleDOI
Course in Parkinson disease subtypes A 39-year clinicopathologic study
TL;DR: The three subtypes of Parkinson disease have different courses which are concordant with the differences in brain biochemical abnormalities, and the course was most favorable in TD, followed by MX and AR subgroups.
Journal ArticleDOI
Barriers to Exercise in People With Parkinson Disease
Terry D. Ellis,Jennifer K. Boudreau,Tamara R. DeAngelis,Lisa E. Brown,James T. Cavanaugh,Gammon M. Earhart,Matthew P. Ford,K. Bo Foreman,Leland E. Dibble +8 more
TL;DR: Low outcome expectation from exercise, lack of time to exercise, and fear of falling appear to be important perceived barriers to engaging in exercise in people who have PD, are ambulatory, and dwell in the community.
Journal ArticleDOI
Late-stage Parkinson disease
TL;DR: A definition of late-stage PD is proposed to designate patients who have progressed beyond the advanced stage of Parkinson's disease, which is dominated by motor symptoms and NMS that are resistant to levodopa.
References
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Journal ArticleDOI
“Mini-mental state”: A practical method for grading the cognitive state of patients for the clinician
Marshal F. Folstein,Marshal F. Folstein,Susan E B Folstein,Susan E B Folstein,Paul R. McHugh,Paul R. McHugh +5 more
TL;DR: A simplified, scored form of the cognitive mental status examination, the “Mini-Mental State” (MMS) which includes eleven questions, requires only 5-10 min to administer, and is therefore practical to use serially and routinely.
A practical method for grading the cognitive state of patients for the clinician
TL;DR: The Mini-Mental State (MMS) as mentioned in this paper is a simplified version of the standard WAIS with eleven questions and requires only 5-10 min to administer, and is therefore practical to use serially and routinely.
Journal ArticleDOI
Parkinsonism: Onset, progression, and mortality
Margaret M. Hoehn,Melvin D. Yahr +1 more
TL;DR: Controversy over the effectiveness of therapeutic measures for parkinsonism is due partially to this wide variability and to the paucity of clinical information about the natural history of the syndrome.
Journal ArticleDOI
The Disablement Process.
Lois M. Verbrugge,Alan M. Jette +1 more
TL;DR: This article compares the disablement experiences of people who acquire chronic conditions early in life and those who acquire them in mid or late life (late-life disability), which can help inform research and public health activities.
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