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Association between Parkinson’s Disease subtypes and tests of physical function: the 360-degree turn test is most predictive

Morgane Prime, View ORCID ProfileJ. Lucas McKay, Allison Bay, Ariel Hart, Chaejin Kim, Amit Abraham, View ORCID ProfileMadeleine E. Hackney
doi: https://doi.org/10.1101/342733
Morgane Prime
1Faculty of Biology, University of Toulouse III - Paul Sabatier, Toulouse, France
3Division of General Medicine and Geriatrics, Department of Medicine, Emory School of Medicine, Atlanta, Georgia, USA
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J. Lucas McKay
2Department of Biomedical Engineering, Emory University and the Georgia Institute of Technology, Atlanta, Georgia, USA
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Allison Bay
3Division of General Medicine and Geriatrics, Department of Medicine, Emory School of Medicine, Atlanta, Georgia, USA
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Ariel Hart
3Division of General Medicine and Geriatrics, Department of Medicine, Emory School of Medicine, Atlanta, Georgia, USA
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Chaejin Kim
3Division of General Medicine and Geriatrics, Department of Medicine, Emory School of Medicine, Atlanta, Georgia, USA
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Amit Abraham
3Division of General Medicine and Geriatrics, Department of Medicine, Emory School of Medicine, Atlanta, Georgia, USA
4Department of Kinesiology, University of Georgia, Athens, GA, USA
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Madeleine E. Hackney
3Division of General Medicine and Geriatrics, Department of Medicine, Emory School of Medicine, Atlanta, Georgia, USA
5Atlanta VA Center for Visual and Neurocognitive Rehabilitation, Decatur, Georgia, USA
6Department of Rehabilitation Medicine, Emory School of Medicine, Atlanta, Georgia, USA
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ABSTRACT

BACKGROUND AND PURPOSE People with Parkinson’s disease (PD) present phenotypes that can be characterized as tremor-dominant (TD) or postural instability / gait difficulty (PIGD) subtypes. Differentiation of subtypes allows clinicians to predict the disease course and adjust treatment accordingly. We examined whether brief mobility and balance measures can discriminate PIGD from TD phenotypes.

METHODS We performed a cross-sectional study with individuals with PD (N=104). Blinded raters assessed participants with the UPDRS or MDS-UPDRS, and potential predictor variables: 360-degree turn test, one-leg stance, backward perturbation test and tandem walk. Participant were classified as PIGD or TD based on the Unified Parkinson’s Disease Rating Scale or the Movement Disorder Society revision (UPDRS or MDS-UPDRS) assessment results. Differences in study variables between subtype groups were assessed with univariate analyses. Receiver operating characteristic (ROC) curve analyses were performed to investigate the ability of candidate predictor variables to differentiate PD subtypes.

RESULTS Mean age and disease duration were 68±9 and 7±5 years, respectively, and Hoehn & Yahr Stages I-IV median (1st,3rd quartile) = II (II, III). No differences between subtypes were observed for tandem walk or reactive postural control. PIGD participants performed worse on number of steps (p<0.001) and time to complete (p=0.003) the 360-degree turn test and one-leg stance (p=0.006). ROC curves showed only the 360-degree turn test could discriminate PIGD from TD with high sensitivity.

CONCLUSIONS The 360-degree turn test requires minimal time to administer and may be useful in mild-moderate PD for distinguishing PIGD from TD subtypes.

Footnotes

  • This study was funded by the United States Department of Veterans Affairs N0870W, National Institutes of Health UL1TR000454, R21HD075612, and K25HD086276. Study was supported by the Emory Center for Health in Aging as well. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Copyright 
The copyright holder for this preprint is the author/funder, who has granted bioRxiv a license to display the preprint in perpetuity. All rights reserved. No reuse allowed without permission.
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Posted June 08, 2018.
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Association between Parkinson’s Disease subtypes and tests of physical function: the 360-degree turn test is most predictive
Morgane Prime, J. Lucas McKay, Allison Bay, Ariel Hart, Chaejin Kim, Amit Abraham, Madeleine E. Hackney
bioRxiv 342733; doi: https://doi.org/10.1101/342733
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Association between Parkinson’s Disease subtypes and tests of physical function: the 360-degree turn test is most predictive
Morgane Prime, J. Lucas McKay, Allison Bay, Ariel Hart, Chaejin Kim, Amit Abraham, Madeleine E. Hackney
bioRxiv 342733; doi: https://doi.org/10.1101/342733

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