Ocenjevanje hoje pri bolnikih s Parkinsonovo boleznijo : pregled literature

Wolf, Valentina (author), Puh, Urška (mentor)

Uvod: Pri bolnikih s Parkinsonovo boleznijo obstajajo za oceno hoje splošna in specifična (lestvica za oceno dejavnosti pri Parkinsonovi bolezni, vprašalnik o zamrznitvah med hojo in test hitrega obrata) merilna orodja, ki so v pomoč pri vrednotenju fizioterapevtske obravnave. Namen: S pregledom literature ugotoviti merske lastnosti merilnih orodij za hojo pri bolnikih s Parkinsonovo boleznijo. Metode dela: Po merilih za vključitev so bili pregledani: literatura v zbirkah podatkov CINAHL, PubMed (MEDLINE) in Cochrane library ter seznami literature v vključenih člankih. Rezultati: V pregled literature je bilo vključenih 27 raziskav. Vsa splošna in specifična merilna orodja za hojo pri bolnikih s Parkinsonovo boleznijo imajo dobro do odlično zanesljivost (ICC = > 0,80; Cα > 0,80). Veljavnost konstrukta splošnih merilnih orodij za hojo z drugimi merilnimi orodji je nizka do dobra (r = 0,32–0,75). Lestvica za oceno dejavnosti pri Parkinsonovi bolezni ter njena modifikacija merita enak konstrukt (ro = 0,92), največjo korelacijo pa ima z združeno ocenjevalno lestvico za Parkinsonovo bolezen in vidno analogno lestvico. Izidi vprašalnika o zamrznitvah so zanemarljivo do zmerno povezani z združeno ocenjevalno lestvico za Parkinsonovo bolezen (II. in III. del) ter zmerno do dobro povezani s postavko 14. Lestvica za oceno funkcionalnosti hoje je dovolj občutljiva za pravilno napoved tveganja za padce (AUC = 0,72–0,86), instrumentalni časovno merjeni vstani in pojdi test je v primerjavi z običajnim testom občutljivejši na motnje hoje, ki se pojavijo pri Parkinsonovi bolezni, vendar ima slabo zanesljivost. Uporaba videoposnetka, ki prikazuje zamrznitve, pri vprašalniku o zamrznitvah ne pripomore k boljši prepoznavi epizod zamrznitev. Najmanjša zaznavna sprememba za 6-minutni test hoje je 82 metrov, dinamični indeks hoje 2,9–3,7 sekunde; časovno merjeni vstani in pojdi test 3,5–11 sekund in lestvico za oceno dejavnosti pri Parkinsonovi bolezni 2 točki. Sklep: Vključena splošna in specifična merilna orodja za hojo pri bolnikih s Parkinsonovo boleznijo imajo dokaj dobro raziskano zanesljivost posameznega preiskovalca in med preiskovalci, veljavnost konstrukta, sočasno, napovedno veljavnost ter najmanjšo zaznavno spremembo, a le za fazo vklopa. V slovenščino bi bilo smiselno prevesti vprašalnik o zamrznitvah med hojo, toda previdno, saj lahko napake v prevodu vplivajo na merske lastnosti vprašalnika.

• Language: Slovenian
• Keywords: Parkinsonova bolezen, ocena hoje, zanesljivost, občutljivost, veljavnost, fizioterapija, merske lastnosti
• Work type: Bachelor thesis/paper
• Organization: ZF - Faculty of Health Sciences
• Year: 2018
• PID: 20.500.12556/RUL-99512
• COBISS.SI-ID: 5387371
• Publication date in RUL: 30.01.2018

Secondary language

• Language: English
• Title: Gait assessment in patients with Parkinson's disease : literature review

Abstract

Introduction: There are general and specific measuring tools for gait assessment in Parkinson’s disease patients (Parkinson activity scale, freezing of gait questionnaire and rapid turns test), that help us evaluate the physiotherapeutic treatment. Purpose: To determine the measuring characteristics of gait assessment measuring tools in Parkinson’s disease patients by analyzing the literature. Methods: According to the inclusion criteria, the following literature was examined: CINHAL, PubMed (MEDLINE) and Cochrane library databases, as well as several articles from the list of literature. Results: 27 surveys were in included in the literature review. The results show that all general and specific measuring tools for gait assessment in Parkinson’s disease patients have good to excellent reliability (ICC = > 0,80; Cα > 0,80). The construct validity of general measuring tools for gait assessment – in comparison with other measuring tools - proved to be low to good (r = 0,32 - 0,75).The Parkinson activity scale and its modification show the same measurement construct (ro = 0,92). The highest correlation is seen with the Unified Parkinson´s disease scale and visual analog scale. The results of the freezing of gait quastionnaire are negligible to moderately linked to the Unified Parkinson´s disease scale (Part II and III), and moderately to well related to the item 14. The functional gait assessment is sufficiently sensitive to correctly predict the risk of falls (AUC = 0,72 - 0,86). In comparison to the general test, the instrumented timed up and go test is more sensitive to the walking disorders that occur in patients with Parkinson's disease; however it has poor reliability. Using a video, showing the episodes of freezing of gait at freezing of gait quastionnaire, does not help to better identify the freezes itself. Minimal detectable change for the 6-minute walking test is 82 meters, for dynamic gait index is 2,9 – 3,7 seconds, for instrumented timed up and go test 3,5 – 11 seconds and for Parkinson´s activity scale 2 points. Conclusion: In Parkinson’s disease patients, the following general and specific gait assessment measuring tools are fairly well-researched: intra-rater and inter-rater reliability, construct, concurrent and predictive validity, as well as minimal detectable change; however only for the on phase. The freezing of gait quastionnaire should be carefully translated into Slovene, as errors in translation may affect the measurement characteristics of the questionnaire itself.

• Keywords: Parkinson's disease, gait assessment, reliability, sensitivity, validity, physiotherapy, psychometric properties