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Background Parkinson's disease ( PD) is characterized by motor and nonmotor symptoms that progress with time, causing disability. The performance of a disease-specific, self-applied tool for assessing disability, the MDS- UPDRS Part II, is tested against generic and rater-based rating scales. Methods An international, cross-sectional, observational study was performed. Patients were assessed with the Hoehn and Yahr ( HY) and five disability measures: MDS- UPDRS Part II, Schwab and England Scale (S&E), Clinical Impression of Severity Index- PD ( CISI- PD) Disability item, Barthel Index ( BI), and Rapid Assessment of Disability Scale ( RADS). Data analysis included correlation coefficients, Mann-Whitney and Kruskal-Wallis tests, and intraclass-correlation coefficient for concordance. Results The sample was composed of 451 patients, 55.2% men, with a mean age of 65.06 years ( SD = 10.71). Disability rating scales correlated from |0.75| ( CISI- PD Disability with BI) to 0.87 ( MDS- UPDRS Part II with RADS). In general, MDS- UPDRS Part II showed high correlation coefficients with clinical variables and satisfactory concordance with the rest of disability measures, with ICC ranging from 0.83 (with BI) to 0.93 (with RADS). All disability rating scales showed statistical significant differences in the sample grouped by sex, age, disease duration, and severity level. Conclusions The MDS- UPDRS Part II showed an appropriate performance to assess disability in PD, even better than some rater-based, generic or specific, scales applied in this study. [ABSTRACT FROM AUTHOR]

Background Severity of PD is usually assessed by means of the motor and disability-based Hoehn and Yahr staging (HY), or clinician and patient global perceptions. Scores of more detailed assessments, as the MDS-UPDRS, have not been translated to a grading that allows assignment of score sections to severity levels. The objective of the present study is to determine cut-off points for PD severity levels based on the MDS-UPDRS. Methods International, observational study. Applied assessments were: HY, MDS-UPDRS, Clinical Impression for Severity Index, and Clinical and Patient Global Impression of Severity. The coincidence in severity level (mild, moderate, severe) of at least two clinical classifications plus the patient's gradation was considered “the criterion of severity”. Cut-off values for each MDS-UPDRS subscale was determined by triangulation of: 1) percentile 90 of the subscale total score; 2) receiver operating characteristic (ROC) analysis; and 3) ordinal logistic regression (OLR) model. Results Sample was composed of 452 consecutive PD patients without dementia, 55.3% males, age 65.1 ± 10.7 years and PD duration 8.7 ± 6.3 years. All HY stages were represented. The “criterion”, classified 275 patients (60.8% of the sample) as: mild PD, 149 (54.2%); moderate, 82 (29.8%); and severe, 44 (16%). The following MDS-UPDRS cut-off points between mild/moderate and moderate/severe levels were found: Part 1: 10/11 and 21/22; Part 2: 12/13 and 29/30; Part 3: 32/33 and 58/59; and Part 4: 4/5 and 12/13. Conclusion Cut-off points to classify PD patients as mild, moderate, or severe on the basis of their MDS-UPDRS scores are proposed. [ABSTRACT FROM AUTHOR]

A relationship between decline in mobility and walking performance and cognitive impairment exists in the elderly. Therefore, clinical assessment of gait and mobility may be relevant for diagnostic and therapeutic purposes. However, the rating scales used for evaluation of gait disorder in the context of cognitive deterioration were not designed or validated for that setting. The present study was aimed at checking the clinimetric properties of the Rating Scale for Gait Evaluation in Cognitive Deterioration (RSGE-CD), specifically developed for assessment of gait dysfunction across all stages of cognitive decline. Two hundred fifty six subjects were included in the study and classified according to the Global Deterioration Scale (control, subjective/mild cognitive impairment, or dementia). Patients with dementia had a diagnosis of probable Alzheimer's disease (73%) or dementia of combined etiology (27%). Cognitive and functional evaluations, the Tinetti scale, and timed tests were simultaneously applied with the tested scale, which is composed of two subscales: Functional ability and Examination. Exploratory factor analysis showed one factor (70% of the variance). Floor effect and skewness were observed in the control group, whereas internal consistency (Cronbach's alpha = 0.88-0.95), inter-observer and test-retest reliability (intraclass correlation coefficients ≥0.97) were satisfactory. Convergent validity with the other measures was ≥0.60 and the discriminant validity according to classification of subjects by cognitive state and other aspects was also satisfactory (p = 0.0001). The RSGE-CD showed low standard errors of measurement. In this first validation study, the RSGE-CD showed satisfactory clinimetric attributes for assessing gait and mobility across the complete range of cognitive state. [ABSTRACT FROM AUTHOR]

Abstract: This study sought to analyse certain metric characteristics of the Ecuadorian version (EV) of the Parkinson''s Disease Questionnaire (PDQ-39 EV). A cross-sectional study was conducted on 137 Parkinson''s disease (PD) patients attending a Movement Disorders Unit. Neurologists'' assessments were based on Hoehn and Yahr (HY), Schwab and England and Unified Parkinson''s Disease Rating Scales. Patients'' self-evaluations included the Hospital Anxiety and Depression Scale, the Parkinson''s Disease Quality of Life questionnaire (PDQL EV), and the PDQ-39 EV. Analyses for acceptability, internal consistency, precision, and construct validity (convergent and known-groups) were performed. Distribution of scores was satisfactory. There was no evidence of floor or ceiling effects. Although the alpha coefficient exceeded 0.70 for mobility, activities of daily living (ADL) and stigma, it was nevertheless low for bodily discomfort (0.48), communication (0.40), and social support (0.33). Fourteen items yielded low correlation coefficients (<0.40) with their respective dimensions. Correlation of social support and bodily discomfort with the Summary Index (SI) was modest (0.46 and 0.36, respectively). PDQ-39 EV SI convergent validity with the PDQL EV SI was very high (r S=−0.91), and known-groups validity proved satisfactory. Results agreed in part with those yielded by an international study, identifying specific flaws probably linked to socio-cultural influence. [Copyright &y& Elsevier]

Abstract: Objective: The SCOPA–Motor Scale (S-MS) for assessment of Parkinson''s disease (PD), contains 21 items in three domains: Motor examination, Disability, and Complications. Our objective was to validate the S-MS Spanish version. Study Design and Setting: This validation study was based on a multicenter, cross-sectional, one-point-in-time evaluation design. The applied measures were: Unified Parkinson''s Disease Rating Scale-3.0 (UPDRS); S-MS; PD Global Evaluation (PDGE); and Clinical Global Impression of severity (CGI). Completeness of data collection, floor and ceiling effect, internal consistency, precision, and construct and discriminative validity were analyzed in 151 PD patients. Results: Scores from S-MS were fully computable. Floor effect was high for Complications (43.7%). Cronbach''s α was >0.90 for every domain, and item–total correlation was >0.70 except for Examination. Standard error of measurement (SEM) ranged from 0.40 to 2.4. Convergent validity with corresponding UPDRS sections yielded coefficients>0.90. Discriminative validity across Hoehn and Yahr (HY) and CGI stages was significant (Kruskal–Wallis, P < .0001). Insofar as internal consistency was concerned, α-values of the Examination sections were marginally higher for the UPDRS than for the S-MS (a finding perhaps accounted for by redundancy in this part of the UPDRS). Conclusion: The S-MS is a consistent and valid scale, shorter by almost half than the UPDRS. [Copyright &y& Elsevier]

AbstractPurposeMethodsResultsConclusions\nImplications for rehabilitationTo translate and cross-culturally adapt the King’s Parkinson’s Disease Pain Scale (KPPS) into Spanish.The English KPPS was forward translated into Spanish, back translated, and revised by the original developers. Cross-cultural adaptation of relevant target groups was conducted following COSMIN standards. Cognitive pretesting in Spanish people with Parkinson’s Disease (PD) and pain was performed via three semi-structured focus group meetings. Changes were implemented based on qualitative and quantitative analyses. A Delphi study (two rounds) of individual assessments by Spanish experts was conducted. Changes were implemented based on the Content Validity Index (CVI) at item and scale levels (I-CVI/S-CVI).Five Spanish professionals performed the initial translation. Thirty-eight inter-translation inconsistencies were identified, and consensus was reached for a unified version. After back translation and confirmation with scale developers, the pre-final Spanish KPPS was obtained. Cognitive pretesting in 30 people with PD-related pain identified 5 items where terminology changes were made to assure comprehensibility. The Delphi study in 14 Spanish experts underlined the necessity to further modify two items. After the second round, all experts agreed on the modifications and I-CVI and S-CVI were satisfactory.The KPPS was successfully translated and cross-culturally adapted into Spanish.The King’s Parkinson’s Disease Pain Scale (KPPS) was translated into Spanish by 5 independent experts.Cross-cultural validity was assessed by Spanish Parkinson’s Disease (PD) patients and neurology experts.The Spanish KPPS adaptation was relevant, understandable, and comprehensive.Rehabilitation professionals will have access to the Spanish KPPS version for assessing PD-related pain in Spanish speaking patients.The King’s Parkinson’s Disease Pain Scale (KPPS) was translated into Spanish by 5 independent experts.Cross-cultural validity was assessed by Spanish Parkinson’s Disease (PD) patients and neurology experts.The Spanish KPPS adaptation was relevant, understandable, and comprehensive.Rehabilitation professionals will have access to the Spanish KPPS version for assessing PD-related pain in Spanish speaking patients. [ABSTRACT FROM AUTHOR]