Bouça-Machado Raquel, Duarte Gonçalo S, Patriarca Maria, Castro Caldas Ana, Alarcão Joana, Fernandes Ricardo M, Mestre Tiago A, Matias Ricardo, Ferreira Joaquim J
Instituto de Medicina Molecular, Faculdade de Medicina Universidade de Lisboa Lisbon Portugal.
CNS-Campus Neurológico Sénior Torres Vedras Portugal.
Mov Disord Clin Pract. 2019 Dec 11;7(2):129-139. doi: 10.1002/mdc3.12874. eCollection 2020 Feb.
Functional mobility (FM) is a person's ability to move to accomplish activities of daily living; it bridges the concepts of mobility and functional ability. There is frequently a loss of FM in Parkinson's disease (PD). Several instruments have been used to assess this concept in PD; however, there is no consensus on which are the most appropriate.
We aimed to identify and critically appraise which measurement instruments have been used to assess FM.
A systematic review was conducted using the databases CENTRAL, MEDLINE, Embase, and PEDro from their inception to January 2019 to identify all observational and experimental studies conducted in PD or atypical parkinsonism that included an FM assessment. Two reviewers independently screened citations, extracted data, and assessed clinimetric properties.
We included 95 studies that assessed FM in PD. Fifty-five (57.9%) studies mentioned FM in the article, and 39 (41.1%) specified the measurement tools used to evaluate FM. FM was the primary outcome in 12 (12.6%) studies. The Timed Up and Go test was the most frequently used measurement tool. Only one study presented a definition of FM. Several overlapping terms were used, the most common being mobility.
Several studies reported the use of FM measurement tools in PD, though with frequent misconceptions, an inadequate context of use, or suboptimal assessment. We propose the establishment of the concept of FM applied to PD, followed by the adequate clinimetric validation of existing measurement tools to provide a comprehensive and reliable evaluation of FM in PD.
功能性移动能力（FM）是指个体为完成日常生活活动而进行移动的能力；它连接了移动能力和功能能力这两个概念。帕金森病（PD）患者常常会出现功能性移动能力丧失的情况。已有多种工具用于评估PD患者的这一概念；然而，对于哪些工具最为合适，尚无共识。
我们旨在识别并批判性评价用于评估功能性移动能力的测量工具。
进行一项系统综述，使用CENTRAL、MEDLINE、Embase和PEDro数据库，检索自其创建至2019年1月期间在PD或非典型帕金森综合征中开展的所有包含功能性移动能力评估的观察性和实验性研究。两名评审员独立筛选文献、提取数据并评估测量特性。
我们纳入了95项评估PD患者功能性移动能力的研究。55项（57.9%）研究在文章中提及了功能性移动能力，39项（41.1%）明确了用于评估功能性移动能力的测量工具。12项（12.6%）研究将功能性移动能力作为主要结局。定时起立行走测试是最常用的测量工具。仅有一项研究给出了功能性移动能力的定义。使用了几个重叠的术语，最常见的是移动能力。
多项研究报告了在PD中使用功能性移动能力测量工具的情况，但常常存在误解、使用背景不充分或评估欠佳的问题。我们建议确立适用于PD的功能性移动能力概念，随后对现有测量工具进行充分的测量特性验证，以全面、可靠地评估PD患者的功能性移动能力。
