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The clinimetrics of hypokinesia in Parkinson's disease: Subjective versus objective assessment

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Journal of Neural Transmission - Parkinson's Disease and Dementia Section

Summary

In this study we evaluate the feasibility of measures that reflect different characteristics of motor activity and immobility in the objective quantification of hypokinesia. Because by definition hypokinesia can only be assessed over a period of time, continuous activity monitoring was used during 5 successive days in the home setting in 64 patients with Parkinson's disease (PD) and 104 healthy elderly subjects. In the patients we also evaluated the relation between the monitor measures and subjective measures of hypokinesia and age. Compared to the healthy elderly subjects, PD patients have a decreased activity level, increased proportion of time without movement, elevated mean duration of immobility, and decreased percentage of short-lasting immobility periods. Differences between both groups were most prominent for those measures that incorporate or reflect immobility. Moreover, in the PD patients the mean duration of immobility and percentage of short-lasting immobility periods show an apparent lack of relation with age and clinical ratings obtained from the UPDRS. In conclusion, our findings underscore the poor representation of hypokinesia in the UPDRS and value of objective quantification of this fundamental impairment of PD.

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References

  • Fahn S, Elton RL, and members of the UPDRS Development Committee (1987) The Unified Parkinson's Disease Rating Scale. In: Fahn S, Marsden SD, Calne DB, Goldstein M (eds) Recent developments in Parkinson's disease, vol 2. Macmillan Healthcare Information, Florham Park, New Jersey, pp 153–163

    Google Scholar 

  • Folstein M, Folstein S, McHugh PJ (1975) “Mini-mental State”: a practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 12: 189–198

    Article  PubMed  Google Scholar 

  • Hilten van JJ, Middelkoop HAM, Kerkhof GA, Roos RAC (1991) The assessment of motor activity in Parkinson's disease: a new approach. J Neurol Neurosurg Psychiatry 54: 976–979

    PubMed  Google Scholar 

  • Hilten van JJ, Hoogland G, Velde van der EA, Kerkhof GA, Dijk van JG, Roos RAC (1993a) Quantitative assessment of parkinsonian patients by continuous wrist activity monitoring. Clin Neuropharmacol 16: 36–45

    PubMed  Google Scholar 

  • Hilten van JJ, Middelkoop HAM, Kuiper SIR, Kramer CGS, Roos RAC (1993b) Wherer. to recomotor activity: an evaluation of commonly used sites of placement for activity monitor. Electroencephalogr Clin Neurophysiol 89: 359–362

    Article  PubMed  Google Scholar 

  • Hilten van JJ, Hof JI, Roos RAC (1993c) Ambulatory activity monitoring: an evaluation of intra-subject variability in Parkinson's disease and healthy elderly. J Ambulat Monitor 6: 219–223

    Google Scholar 

  • Kramer CGS, Middelkoop HAM, Hilten van JJ, Kamphuisen HAC (1992) Actplan and actstat: software programs for analyzing motor activity data as obtained with commerical actigraphs. J Ambulat Monitor 5: 331–340

    Google Scholar 

  • Lakke JWPF (1990) Assessment and measurement. In: Stern G (ed) Parkinson's disease. Chapman and Hall Medical, London, pp 467–491

    Google Scholar 

  • Marsden CD (1989) Slowness of movement in Parkinson's disease. Mov Disord 4: S26-S37

    Article  PubMed  Google Scholar 

  • Montgomery SA, Åsberg M (1979) A new depression scale designed to be sensitive to change. Br J Psychiatry 134: 382–389

    PubMed  Google Scholar 

  • Tinetti ME (1986) Performance-oriented assessment of mobility problems in elderly patients. J Am Geriatr Soc 34: 119–126

    PubMed  Google Scholar 

  • Yahr MD, Duvoisin RC, Schear MJ, Barrett RE, Hoehn MM (1969) Treatment of parkinsonism with levodopa. Arch Neurol 21: 343–354

    PubMed  Google Scholar 

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van Hilten, J.J., Hoff, J.I., Middelkoop, H.A.M. et al. The clinimetrics of hypokinesia in Parkinson's disease: Subjective versus objective assessment. J Neural Transm Gen Sect 8, 117–121 (1994). https://doi.org/10.1007/BF02250922

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  • DOI: https://doi.org/10.1007/BF02250922

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