Neurology Department, Hospital Universitario Burgos, Spain; University of Burgos, Spain.
Neurology Department, Hospital Universitario Burgos, Spain; University of Burgos, Spain.
Parkinsonism Relat Disord. 2023 Sep;114:105773. doi: 10.1016/j.parkreldis.2023.105773. Epub 2023 Aug 3.
The evaluation of motor impairment in Parkinson's disease (PD) is mainly assessed with the motor subdomain of the Unified Parkinson's Disease Rating scale (UPDRS part III) and, lately, with the MDS-UPDRS part III. To optimize efforts and special needs during specific circumstances in clinical practice, we sought to identify the most sensitive items to assess motor impairment in PD.
We included the COPPADIS-PD cohort and collected the UPDRS part III at baseline (V0), 12 months (V1), and 24 months (V2). Factor analysis and effect size using Cohen's d formula were performed in the Off and On states at V0, V1, and V2.
We included 667 patients with PD, mean age of 62.59 ± 8.91 years, 410 (60.2%) males, with a median HY stage of 2.00 (1.00; 4.00) at baseline. Over time, the most discriminating items were postural stability and body bradykinesia ("arise from chair" and "gait") in the Off state, right and left upper extremity bradykinesia ("finger tap", "hand movements" and "prono/supination") in the On state. Body bradykinesia and right-left finger tapping were the items with the largest effect size (0.93, 0.84, 0.83, respectively) to assess motor improvement after receiving antiparkinsonian medications over time.
Under specific circumstances, selecting a few items of the UPDRS part III, including postural stability, body bradykinesia, and upper extremity bradykinesia, could be used to create a quick clinical judgment of motor status and improvement in PD.
帕金森病（PD）运动障碍的评估主要采用统一帕金森病评定量表（UPDRS）运动子域和最近的 MDS-UPDRS 第三部分进行评估。为了在临床实践中的特殊情况下优化工作和特殊需求，我们试图确定最敏感的项目来评估 PD 中的运动障碍。
我们纳入了 COPPADIS-PD 队列，并在基线（V0）、12 个月（V1）和 24 个月（V2）时收集 UPDRS 第三部分。在 V0、V1 和 V2 的 Off 和 On 状态下进行因子分析和使用 Cohen's d 公式计算效应量。
我们纳入了 667 名 PD 患者，平均年龄为 62.59 ± 8.91 岁，410 名（60.2%）男性，基线时 HY 分期中位数为 2.00（1.00；4.00）。随着时间的推移，在 Off 状态下最具鉴别力的项目是姿势稳定性和身体运动迟缓（“从椅子上站起来”和“步态”），在 On 状态下最具鉴别力的项目是右侧和左侧上肢运动迟缓（“手指敲击”、“手部运动”和“旋前/旋后”）。身体运动迟缓以及右侧和左侧手指敲击是评估随着时间推移接受抗帕金森病药物治疗后运动改善的具有最大效应量（分别为 0.93、0.84、0.83）的项目。
在特殊情况下，选择 UPDRS 第三部分的几个项目，包括姿势稳定性、身体运动迟缓以及上肢运动迟缓，可以用于快速临床判断 PD 的运动状态和改善情况。
