Quantitative Timed-Up-and-Go Parameters in Relation to Cognitive Parameters and Health-Related Quality of Life in Mild-to-Moderate Parkinson's Disease

The instrumented-Timed-Up-and-Go test (iTUG) provides detailed information about the following movement patterns: sit-to-walk (siwa), straight walking, turning and walk-to-sit (wasi). We were interested in the relative contributions of respective iTUG sub-phases to specific clinical deficits most re...

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Bibliographic Details
Published in:PloS one 2016-04, Vol.11 (4), p.e0151997-e0151997
Main Authors: Van Uem, Janet M T, Walgaard, Stefan, Ainsworth, Erik, Hasmann, Sandra E, Heger, Tanja, Nussbaum, Susanne, Hobert, Markus A, Micó-Amigo, Encarnación M, Van Lummel, Rob C, Berg, Daniela, Maetzler, Walter
Format: Article
Language:English
Subjects:
Activities of daily living
Aged
Algorithms
Archives & records
Automation
Biology and Life Sciences
Biomechanical Phenomena
Brain research
Case-Control Studies
Cognition
Cognitive ability
Cognitive disorders
Complications and side effects
Cross-Sectional Studies
Disability
Drugs
Executive function
Female
Gait Disorders, Neurologic - physiopathology
Humans
Male
Medicine and Health Sciences
Middle Aged
Movement disorders
Netherlands
Neural networks
Neurodegeneration
Neurodegenerative diseases
Neurology
Neuropsychology
Neurosciences
Parkinson disease
Parkinson Disease - physiopathology
Parkinson's disease
Patients
Phases
Physical Sciences
Postural Balance
Prospective Studies
Psychological aspects
Quality of Life
Risk factors
Short term memory
Society
Time Factors
Walking
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Description
Summary:The instrumented-Timed-Up-and-Go test (iTUG) provides detailed information about the following movement patterns: sit-to-walk (siwa), straight walking, turning and walk-to-sit (wasi). We were interested in the relative contributions of respective iTUG sub-phases to specific clinical deficits most relevant for daily life in Parkinson's disease (PD). More specifically, we investigated which condition-fast speed (FS) or convenient speed (CS)-differentiates best between mild- to moderate-stage PD patients and controls, which parameters of the iTUG sub-phases are significantly different between PD patients and controls, and how the iTUG parameters associate with cognitive parameters (with particular focus on cognitive flexibility and working memory) and Health-Related-Quality of Life (HRQoL). Twenty-eight PD participants (65.1 ± 7.1 years, H&Y stage 1-3, medication OFF state) and 20 controls (66.1 ± 7.5 years) performed an iTUG (DynaPort®, McRoberts BV, The Netherlands) under CS and FS conditions. The PD Questionnaire 39 (PDQ-39) was employed to assess HRQoL. General cognitive and executive functions were assessed using the Montreal Cognitive Assessment and the Trail Making Test. The total iTUG duration and sub-phases durations under FS condition differentiated PD patients slightly better from controls, compared to the CS condition. The following sub-phases were responsible for the observed longer total duration PD patients needed to perform the iTUG: siwa, turn and wasi. None of the iTUG parameters correlated relevantly with general cognitive function. Turning duration and wasi maximum flexion velocity correlated strongest with executive function. Walking back duration correlated strongest with HRQoL. This study confirms that mild- to moderate-stage PD patients need more time to perform the iTUG than controls, and adds the following aspects to current literature: FS may be more powerful than CS to delineate subtle movement deficits in mild- to moderate-stage PD patients; correlation levels of intra-individual siwa and wasi parameters may be interesting surrogate markers for the level of automaticity of performed movements; and sub-phases and kinematic parameters of the iTUG may have the potential to reflect executive functioning and HRQoL aspects of PD patients.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0151997