Clinical and device-based predictors of improved experience of activities of daily living after a multidisciplinary inpatient treatment for people with Parkinson's disease: a cohort study.

IF 5.4 3区材料科学 Q2 CHEMISTRY, PHYSICAL

ACS Applied Energy Materials Pub Date : 2024-09-23 eCollection Date: 2024-01-01 DOI:10.1177/17562864241277157

Judith Oppermann, Vera Tschentscher, Julius Welzel, Johanna Geritz, Clint Hansen, Ralf Gold, Walter Maetzler, Raphael Scherbaum, Lars Tönges

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引用次数: 0

Abstract

Background: The inpatient Parkinson's Disease Multimodal Complex Treatment (PD-MCT) is an important therapeutical approach to improving gait and activities of daily living (ADL) of people with PD (PwP). Wearable device-based parameters (DBP) are new options for specific gait analyses toward individualized treatments.

Objectives: We sought to identify predictors of perceived ADL benefit taking clinical scores and DBP into account. Additionally, we analyzed DBP and clinical scores before and after PD-MCT.

Design: Exploratory observational cohort study.

Methods: Clinical scores and DBP of 56 PwP (mean age: 66.3 years, median Hoehn and Yahr (H&Y) stage: 2.5) were examined at the start and the end of a 14-day inpatient PD-MCT in a German University Medical Center. Participants performed four straight walking tasks under single- and dual-task conditions for gait analyses. Additionally, clinical scores of motor and nonmotor functions and quality of life (QoL) were assessed. Using dichotomized data of change in Movement Disorders Society Unified Parkinson's Disease Rating Scale Part II (MDS-UPDRS II) as a dependent variable and clinical and DBP as independent variables, a binomial logistic regression model was implemented.

Results: Young age, high perceived ADL impairment at baseline, high dexterity skills, and a steady gait were significant predictors of ADL benefit after PD-MCT. DBP like gait speed, number of steps, step time, stance time, and double limb support time were improved after PD-MCT. In addition, motor functions (e.g., MDS-UPDRS III and IV), QoL, perceived ADL (MDS-UPDRS II), and experience of nonmotor functions (MDS-UPDRS I) improved significantly.

Conclusion: The logistic regression model identified a group of PwP who had the most probable perceived ADL benefit after PD-MCT. Additionally, gait improved toward a faster and more dynamic gait. Using wearable technology in context of PD-MCT is promising to offer more personalized therapeutical concepts.

Trial registration: German Clinical Trial Register, https://drks.de; DRKS00020948 number, 30 March 2020, retrospectively registered.

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帕金森病患者接受多学科住院治疗后日常生活活动能力改善的临床和设备预测因素：一项队列研究。

背景：住院帕金森病多模式综合治疗（PD-MCT）是改善帕金森病患者（PwP）步态和日常生活活动（ADL）的重要治疗方法。基于可穿戴设备的参数（DBP）是进行特定步态分析以实现个性化治疗的新选择：我们试图通过临床评分和 DBP 来确定感知 ADL 益处的预测因素。此外，我们还分析了 PD-MCT 前后的 DBP 和临床评分：探索性观察队列研究：在德国一所大学医疗中心进行的为期 14 天的 PD-MCT 住院治疗开始和结束时，对 56 名 PwP（平均年龄：66.3 岁，Hoehn 和 Yahr（H&Y）分期中位数：2.5）的临床评分和 DBP 进行了检查。受试者在单任务和双任务条件下完成了四次直线行走任务，以进行步态分析。此外，还对运动和非运动功能的临床评分以及生活质量（QoL）进行了评估。以运动障碍协会统一帕金森病评分量表第二部分（MDS-UPDRS II）的二分法变化数据为因变量，以临床和DBP为自变量，建立了一个二项逻辑回归模型：结果：年龄小、基线时感知到的ADL损伤程度高、灵巧技能高和步态稳定是PD-MCT后ADL获益的重要预测因素。PD-MCT治疗后，步速、步数、步幅、站立时间和双肢支撑时间等DBP指标均有所改善。此外，运动功能（如MDS-UPDRS III和IV）、QoL、ADL感知（MDS-UPDRS II）和非运动功能体验（MDS-UPDRS I）也有显著改善：逻辑回归模型确定了一组在 PD-MCT 治疗后最有可能在感知 ADL 方面获益的残疾人。此外，步态也有所改善，变得更快、更有活力。在PD-MCT中使用可穿戴技术有望提供更加个性化的治疗理念：德国临床试验注册中心，https://drks.de；DRKS00020948编号，2020年3月30日，回顾性注册。

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来源期刊

ACS Applied Energy Materials Materials Science-Materials Chemistry

CiteScore

10.30

自引率

6.20%

发文量

1368

期刊介绍： ACS Applied Energy Materials is an interdisciplinary journal publishing original research covering all aspects of materials, engineering, chemistry, physics and biology relevant to energy conversion and storage. The journal is devoted to reports of new and original experimental and theoretical research of an applied nature that integrate knowledge in the areas of materials, engineering, physics, bioscience, and chemistry into important energy applications.