Bowman Thomas, Gervasoni Elisa, Parelli Riccardo, Jonsdottir Johanna, Ferrarin Maurizio, Cattaneo Davide, Carpinella Ilaria
IRCCS Fondazione Don Carlo Gnocchi, Via Capecelatro 66, 20148 Milan, Italy.
Arch Physiother. 2018 Dec 27;8:10. doi: 10.1186/s40945-018-0051-2. eCollection 2018.
Parkinson's disease impacts health-related quality of life (HRQoL), however no studies inquired on predictors of HRQoL changes after rehabilitation. This study assessed the relationship between mobility domain of HRQoL measured by Parkinson's Disease Questionnaires-39 (PDQ-39) and clinical-demographic characteristics and developed a model predicting changes after rehabilitation.
Subjects with Parkinson's disease underwent rehabilitation treatment and completed the following predictors: 10-m walking test (10MWT), Timed Up and Go (TUG), Berg Balance scale (BBS), Activities-specific Balance Confidence scales (ABC), Freezing of Gait (FOGQ) and PDQ-39. Two general linear models were calculated to predict the relationship between HRQoL at baseline and to predict HRQoL changes after rehabilitation.
Forty-two subjects (age 74.9 ± 7.3 years, Hoehn&Yahr 2.8 ± 0.6) completed the baseline evaluation. The first model (multiple R = 0.59, F = 5.86, < 0.001) showed that ABC (B = - 0.51, CI = - 0.86 to 0.15, R = 0.41, = 0.005) and FOGQ (B = 2.38, CI = 1.03 to 3.73, R = 0.07, = 0.001) were statistically significant predictors of mobility aspect of HRQoL at baseline. Thirty seven subjects completed the rehabilitation sessions, data were entered in the second model (multiple R = 0.40, F = 4.24, < 0.004) showing that gender (B = - 5.12, CI = - 9.86 to - 0.39, R = 0.23, = 0.034), Hoehn&Yahr (B = 10.93, CI = + 3.27 to + 18.61, R = 0.22, = 0.006) and PDQ-39 mobility at baseline (B = - 0.38, CI = - 0.63 to - 0.14, R = 0.55, = 0.002) were statistically significant predictors of changes of the mobility aspect of HRQoL.
Balance confidence and Freezing of Gait are associated with the mobility aspect of HRQoL. Changes in mobility domain of HRQoL (as assessed by PDQ-39) are likely to be greater in males, in people at higher stages of the disease and in people with more severe limitation in mobility domain of HRQoL (as assessed by PDQ-39) before rehabilitation. Results might be different when considering different outcomes or different measures for the same outcome (performance mobility test instead of self-report questionnaires). Further investigations are needed to better understand other components of HRQoL in addition to mobility.
NCT02713971 registered March 8, 2016.
帕金森病会影响健康相关生活质量（HRQoL），然而尚无研究探讨康复后HRQoL变化的预测因素。本研究评估了用帕金森病问卷-39（PDQ-39）测量的HRQoL的活动能力领域与临床人口统计学特征之间的关系，并建立了一个预测康复后变化的模型。
帕金森病患者接受康复治疗，并完成以下预测指标：10米步行测试（10MWT）、起立行走测试（TUG）、伯格平衡量表（BBS）、特定活动平衡信心量表（ABC）、步态冻结量表（FOGQ）和PDQ-39。计算两个一般线性模型，以预测基线时HRQoL之间的关系，并预测康复后HRQoL的变化。
42名受试者（年龄74.9±7.3岁，Hoehn&Yahr分级2.8±0.6）完成了基线评估。第一个模型（复相关系数R=0.59，F=5.86，P<0.001）显示，ABC（B=-0.51，可信区间CI=-0.86至-0.15，R=0.41，P=0.005）和FOGQ（B=2.38，CI=1.03至3.73，R=0.07，P=0.001）是基线时HRQoL活动能力方面的统计学显著预测因素。37名受试者完成了康复疗程，数据输入第二个模型（复相关系数R=0.40，F=4.24，P<0.004），结果显示性别（B=-5.12，CI=-9.86至-0.39，R=0.23，P=0.034）、Hoehn&Yahr分级（B=10.93，CI=+3.27至+18.61，R=0.22，P=0.006）和基线时PDQ-39活动能力（B=-0.38，CI=-0.63至-0.14，R=0.55，P=0.002）是HRQoL活动能力方面变化的统计学显著预测因素。
平衡信心和步态冻结与HRQoL的活动能力方面相关。HRQoL活动能力领域的变化（通过PDQ-39评估）在男性、疾病晚期患者以及康复前HRQoL活动能力领域受限更严重的患者（通过PDQ-39评估）中可能更大。当考虑不同的结果或同一结果的不同测量方法（性能活动测试而非自我报告问卷）时，结果可能会有所不同。除活动能力外，还需要进一步研究以更好地了解HRQoL的其他组成部分。
NCT02713971，于2016年3月8日注册。
