Harper Kristie, Jacques Angela, Burton Melanie, Richmond Janet, Barry Lisa
Sir Charles Gairdner Osborne Park Health Care Group, Occupational Therapy, Perth, WA, Australia.
School of Allied Health, Curtin University, Bentley, WA, Australia.
Br J Occup Ther. 2025 Apr 22;88(9):544-552. doi: 10.1177/03080226251335226. eCollection 2025 Sep.
Upper limb dysfunction is common in people with Parkinson's. This study aimed to pilot and establish the initial psychometric properties of the timed upper limb assessment (TULA), a 10-item timed functional upper limb assessment tool.
A prospective observational study was conducted with 381 participants (202 with Parkinson's, 179 controls). The TULA was administered to both groups, with inter-rater reliability assessed in a subset ( = 47). Principal component analysis examined structural validity, while convergent validity was explored through correlations with cognitive and motor assessments.
The TULA demonstrated high internal consistency (Cronbach's α = 0.81 for Parkinson's group) and high inter-rater reliability (intraclass correlation coefficient (ICC) > 0.9). People with Parkinson's took significantly longer to complete all items (mean (SD) 22.2 ± 7.5) compared to controls (16.8 ± 3.7, < 0.001). The tool showed moderate correlation with the timed up and go test ( = 0.56, < 0.001), a significant low correlation with the Hoehn and Yahr Scale ( = 0.44, ⩽ 0.001) and a significant low correlation with both the Montreal Cognitive Assessment ( = -0.37, ⩽ 0.001) and the Mini Mental Status Examination ( = -0.31, ⩽ 0.001).
This study provides an alternative functional upper limb assessment tool for people with Parkinson's attending occupational therapy. Initial data have been provided to support the reliability and validity of the TULA.
上肢功能障碍在帕金森病患者中很常见。本研究旨在对一项包含10项内容的上肢功能计时评估工具——计时上肢评估(TULA)进行试点研究,并确定其初步的心理测量学特性。
对381名参与者(202名帕金森病患者,179名对照者)进行了一项前瞻性观察研究。两组均接受了TULA评估,其中一个子集(n = 47)评估了评分者间信度。主成分分析检验结构效度,同时通过与认知和运动评估的相关性探讨收敛效度。
TULA显示出高内部一致性(帕金森病组的Cronbach's α = 0.81)和高评分者间信度(组内相关系数(ICC)> 0.9)。与对照组(16.8 ± 3.7,P < 0.001)相比,帕金森病患者完成所有项目的时间明显更长(平均(标准差)22.2 ± 7.5)。该工具与计时起立行走测试显示出中度相关性(r = 0.56,P < 0.001),与霍恩和雅尔分级量表呈显著低相关性(r = 0.44,P ≤ 0.001),与蒙特利尔认知评估(r = -0.37,P ≤ 0.001)和简易精神状态检查表(r = -0.31,P ≤ 0.001)均呈显著低相关性。
本研究为接受职业治疗的帕金森病患者提供了一种替代性的上肢功能评估工具。已提供初步数据以支持TULA的可靠性和有效性。