Parkinson's and Movement Disorders Center of Maryland, Elkridge, MD 21075, USA.
J Parkinsons Dis. 2011;1(3):287-98. doi: 10.3233/JPD-2011-11016.
The Unified Parkinson's Disease Rating Scale (UPDRS) part III is the principal motor assessment method for Parkinson's disease (PD), but has recognized limitations including subjectivity and insensitivity. Easy to administer, objective, quantitative tests that are good indicators of PD progression could offer advantages in both clinical and research settings. We administered four simple, motor performance measures--functional reach, timed hall walk, a timed block sort task, and timed dotting--as well as the UPDRS to 609 PD patients of a single neurologist. The unadjusted Spearman correlations of these performance measures with the UPDRS motor score (UPDRS III) ranged from 0.29 to 0.49. Moreover, these measures generally had high reliability on repeated testing. We defined specific outcomes in PD--overall disability, gait instability and falls, as well as non-motor outcomes of depression, dementia, and psychosis, and assessed the ability of the measures to predict these outcomes over the entire follow-up of the cohort (average: 2.4 years) and over the first year of follow-up. The associations between the measures and the outcomes were generally stronger and more precise for the performance measures than for the UPDRS III. A summary score of the performance measures was a particularly good predictor of the outcomes. These motor performance measures could provide a rapid, simple means of assessing PD progression that could benefit both clinical and research endeavors.
统一帕金森病评定量表（UPDRS）第三部分是帕金森病（PD）的主要运动评估方法，但存在主观性和不敏感性等公认的局限性。易于管理、客观、定量的测试，如果是 PD 进展的良好指标，则在临床和研究环境中都具有优势。我们对一位神经科医生的 609 名 PD 患者进行了四项简单的运动表现测试，包括功能性伸展、定时走廊行走、定时方块分类任务和定时打点测试，以及 UPDRS。这些表现测试与 UPDRS 运动评分（UPDRS III）之间的未经调整的 Spearman 相关系数在 0.29 到 0.49 之间。此外，这些措施在重复测试中通常具有较高的可靠性。我们定义了 PD 的特定结局，包括整体残疾、步态不稳和跌倒，以及抑郁、痴呆和精神病等非运动结局，并评估了这些措施在整个队列随访期间（平均 2.4 年）和随访的第一年中预测这些结局的能力。与 UPDRS III 相比，这些措施与结局之间的关联在表现措施中通常更强且更精确。表现措施的综合评分是预测结局的一个特别好的指标。这些运动表现措施可以提供一种快速、简单的评估 PD 进展的方法，这将有益于临床和研究工作。
