在手部灵巧性方面，双重任务干扰是帕金森病日常生活活动表现的预测指标。

Dual-task interference during hand dexterity is a predictor for activities of daily living performance in Parkinson's disease.

机构信息

Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Ordu University, Turkey.

Department of Neurology, Faculty of Medicine, Ordu University, Turkey.

出版信息

Parkinsonism Relat Disord. 2019 Sep;66:100-104. doi: 10.1016/j.parkreldis.2019.07.017. Epub 2019 Jul 13.

DOI:10.1016/j.parkreldis.2019.07.017

PMID:31324554

Abstract

INTRODUCTION

Dual-task interference (DTI) leads to impairment of hand dexterity in Parkinson's disease (PD). The performance of activities of daily living (ADL) is negatively affected by dexterity in PD. However, the contribution of DTI to dexterity-related ADL disability remains unclear. This cross-sectional study aimed to investigate the contribution of DTI to ADL performance as well as other factors affecting dexterity.

METHODS

One-hundred and eight patients with PD were assessed using the ADL-related dexterity questionnaire-24 to measure dexterity-related ADL performance. Performance in single and dual task conditions was measured with the 9-hole peg test. Disease severity, cardinal symptoms and grip strength were assessed using Hoehn&Yahr, a modified version of the Unified Parkinson Disease Rating Scale, Part-III, and a hand dynamometer. The age and cognitive status were control variables.

RESULTS

Multiple regression analysis revealed that disease severity explained 8.5% of the variance in dexterity-related ADL (p = 0.002). The DTI in the dominant hand was the strongest predictor of ADL performance (R change = 0.44, p < 0.001), but DTI in the non-dominant hand did not contribute. When cardinal symptoms were added to the model, bradykinesia contributed to ADL difficulty (R change = 0.072, p < 0.001), while tremor and rigidity were not significant in any model. This model accounted for 59.2% of the variance in ADL difficulties in total.

CONCLUSION

The study demonstrated that disease severity, bradykinesia and DTI in the dominant hand contributed to ADL difficulties in patients with PD, and DTI in the dominant hand is the strongest predictor of ADL performance in PD.

摘要

简介

双重任务干扰（DTI）会导致帕金森病（PD）患者手部灵巧度下降。日常生活活动（ADL）的表现会受到 PD 患者灵巧度的负面影响。然而，DTI 对与灵巧度相关的 ADL 残疾的贡献尚不清楚。本横断面研究旨在调查 DTI 对 ADL 表现以及影响灵巧度的其他因素的贡献。

方法

对 108 名 PD 患者进行评估，使用 ADL 相关灵巧度问卷-24 测量与灵巧度相关的 ADL 表现。使用 9 孔钉测试测量单任务和双任务条件下的表现。使用 Hoehn&Yahr、改良的帕金森病评定量表第三部分和手持测力计评估疾病严重程度、主要症状和握力。年龄和认知状态是控制变量。

结果

多元回归分析显示，疾病严重程度解释了与灵巧度相关的 ADL 表现的 8.5%的方差（p=0.002）。优势手的 DTI 是 ADL 表现的最强预测因子（R 变化=0.44，p<0.001），但非优势手的 DTI 没有贡献。当主要症状被添加到模型中时，运动迟缓导致 ADL 困难（R 变化=0.072，p<0.001），而震颤和僵直在任何模型中都不显著。该模型总共解释了 ADL 困难的 59.2%的方差。