ABSTRACT Background: The Unified Parkinson’s Disease Rating Scale is the most commonly used scale in the clinical study of Parkinson’s disease. However, it may fail to capture the essence of physical impairment in patients with Parkinson’s disease and thus limit responsiveness of care-givers, patients, and/or clinicians as to increasing physical disability. This study sought to compare subjective measures of physical disability in Parkinson’s disease to an objective, accurate, and proven measure of physical function-gait speed. Methods: Eighty-eight individuals with early to moderate stage Parkinson’s disease were evaluated on the Unified Parkinson’s Disease Rating Scale, the Parkinson’s disease Questionnaire 39 and during five 8 meter walking trials. Spearman correlations coefficients were used to determine the association among all variables of interest. Results: The findings demonstrate that only a fair to moderate relationship between objectively measured gait speed and physical function as measured subjectively by the clinical rating scale and as evaluated by the patients during self report. Conclusions: The results of this study suggest that commonly utilized measures of physical function in Parkinson’s disease are not highly correlated with gait speed. Because gait speed is demonstrated as a dependable proxy for physical function, the results of this study may provide a rational for the use of gait speed to provide a more accurate picture of physical function in patients with Parkinson’s disease.
Cite this paper
nullNocera, J. and Hass, C. (2012) Should gait speed be included in the clinical evaluation of Parkinson’s disease?. Advances in Parkinson's Disease, 1, 1-4. doi: 10.4236/apd.2012.11001.
 Hely, M.A., Reid, W.G., Adena, M,A., Halliday, G.M. and Morris, J.G. (2008) The Sydney multicenter study of Parkinson’s disease: The inevitability of dementia at 20 years. Movement Disorders, 23, 837-844. doi:10.1002/mds.21956
Bloem, B.R., Hausdorff, J.M., Visser, J.E. and Giladi, N. (2004) Falls and freezing of gait in Parkinson’s disease: A review of two interconnected, episodic phenomena. Movement Disorders, 19, 871-884. doi:10.1002/mds.20115
Mak, M.K. and Pang, M.Y. (2010) Parkinsonian single fallers versus recurrent fallers: Different fall characteristics and clinical features. Journal of Neuroscience, 257, 1543-1551. doi:10.1007/s00415-010-5573-9
Ramaker, C., Marinus, J., Stiggelbout, A.M. and van Hilten, B.J. (2002) Systematic evaluation of rating scales for impairment and disability in Parkinson’s disease. Movement Disorders, 17, 867-876. doi:10.1002/mds.10248
Bloem. B.R., Beckley, D.J., van Hilten, B.J. and Roos, R.A. (1998) Clinimetrics of postural instability in Parkinson’s disease. Journal of Neuroscience, 245, 669-673. doi:10.1007/s004150050265
Hirsch, C.H., Buzková, P., Robbins, J.A., Patel, K.V. and Newman, A.B. (2012) Predicting late-life disability and death by the rate of decline in physical performance measures. Age Ageing, 41, 155-161. doi:10.1093/ageing/afr151
Portney, L. and Watkins, M. (1993) Foundations of clini-cal research: Applications to practice. Appleton and Lange, Norwalk.
Braun, B.L. (1998) Knowledge and perception of fall- related risk factors and fall-reduction techniques among community-dwelling elderly individuals. Physical Ther-apy, 78, 1262-1276.
Sadowski, C.A., Jones, C.A., Gordon, B. and Feeny, D.H. (2007) Knowledge of risk factors for falling reported by patients with Parkinson disease. Journal of Neuroscience Nursing, 39, 336-341. doi:10.1097/01376517-200712000-00004
Pickering, R.M., Grimbergen, Y.A., Rigney, U., Ashburn, A., Mazibrada, G., Wood, B., et al. (2007) A meta-analysis of six prospective studies of falling in Parkinson’s disease. Movement Disorders, 22, 1892-1900. doi:10.1002/mds.21598
Adkin, A.L., Frank, J.S. and Jog, M.S. (2003) Fear of falling and postural control in Parkinson’s disease. Movement Disorders, 18, 496-502. doi:10.1002/mds.10396
Nocera, J.R., Buckley, T., Waddell, D., Okun M. and Hass. C. (2010) Knee extensor strength, dynamic stability and function ambulation: Are they related in Parkinson’s disease? Archives of Physical Medicine and Rehabilitation, 91, 589-595. doi:10.1016/j.apmr.2009.11.026