Evans Tess, Jefferson Alexa, Byrnes Michelle, Walters Sue, Ghosh Soumya, Mastaglia Frank L, Power Brian, Anderton Ryan S
School of Medicine, University of Notre Dame Australia, Fremantle, WA, Australia.
Western Australian Neuroscience Research Institute, A Block, QEII Medical Centre, Nedlands, WA, Australia.
J Neurol Sci. 2017 Apr 15;375:86-91. doi: 10.1016/j.jns.2017.01.050. Epub 2017 Jan 17.
To evaluate a modified extended Timed Up and Go (extended-TUG) assessment against a panel of validated clinical assessments, as an indicator of Parkinson's disease (PD) severity and cognitive impairment.
Eighty-seven participants with idiopathic PD were sequentially recruited from a Movement Disorders Clinic. An extended-TUG assessment was employed which required participants to stand from a seated position, walk in a straight line for 7m, turn 180° and then return to the start, in a seated position. The extended-TUG assessment duration was correlated to a panel of clinical assessments, including the Unified Parkinson's Disease Rating Scale (MDS-UPDRS), Quality of Life (PDQ-39), Scales for Outcomes in Parkinson's Disease (SCOPA-Cog), revised Addenbrooke's Cognitive Index (ACE-R) and Barratt's Impulsivity Scale 11 (BIS-11).
Extended-TUG time was significantly correlated to MDS-UPDRS III score and to SCOPA-Cog, ACE-R (p<0.001) and PDQ-39 scores (p<0.01). Generalized linear models determined the extended-TUG to be a sole variable in predicting ACE-R or SCOPA-Cog scores. Patients in the fastest extended-TUG tertile were predicted to perform 8.3 and 13.4 points better in the SCOPA-Cog and ACE-R assessments, respectively, than the slowest group. Patients who exceeded the dementia cut-off scores with these instruments exhibited significantly longer extended-TUG times.
Extended-TUG performance appears to be a useful indicator of cognition as well as motor function and quality of life in PD, and warrants further evaluation as a first line assessment tool to monitor disease severity and response to treatment. Poor extended-TUG performance may identify patients without overt cognitive impairment form whom cognitive assessment is needed.
评估改良的延长计时起立行走测试（extended-TUG）与一组经过验证的临床评估方法相比，作为帕金森病（PD）严重程度和认知障碍指标的情况。
从运动障碍诊所连续招募了87名特发性PD患者。采用延长计时起立行走测试，要求参与者从坐姿站立，沿直线行走7米，转身180°，然后回到起始坐姿。延长计时起立行走测试的持续时间与一组临床评估相关，包括统一帕金森病评定量表（MDS-UPDRS）、生活质量（PDQ-39）、帕金森病结局量表（SCOPA-Cog）、修订版Addenbrooke认知量表（ACE-R）和巴拉特冲动性量表11（BIS-11）。
延长计时起立行走测试时间与MDS-UPDRS III评分、SCOPA-Cog、ACE-R（p<0.001）和PDQ-39评分（p<0.01）显著相关。广义线性模型确定延长计时起立行走测试是预测ACE-R或SCOPA-Cog评分的唯一变量。预计在延长计时起立行走测试中最快的三分位数组的患者在SCOPA-Cog和ACE-R评估中分别比最慢的组表现好8.3分和13.4分。使用这些工具超过痴呆症临界分数的患者延长计时起立行走测试时间明显更长。
延长计时起立行走测试表现似乎是PD认知、运动功能和生活质量的有用指标，作为监测疾病严重程度和治疗反应的一线评估工具值得进一步评估。延长计时起立行走测试表现不佳可能识别出需要进行认知评估的无明显认知障碍患者。
