Patient-Reported and Performance-Based Outcome Measures for Functional Mobility and Activity Limitation in Individuals with Parkinson's Disease

Yıl 2020, Cilt: 25 Sayı: 2, 160 - 173, 13.06.2020

Semiha Yenişehir , Veli Batur İlkim Çıtak Karakaya Mehmet Gürhan Karakaya

https://doi.org/10.21673/anadoluklin.622194

Öz

Parkinson Disease which is characterized by motor and non-motor symptoms, is the
second most common neurodegenerative disease after Alzheimer’s disease. Genetic
factors, congenital anomalies, toxic agent exposure, trauma, inflammation,
oxidative stress and damage to dopamine-producing cells in the substantia nigra
located in the deep part of the brain are included in its pathophysiology. Parkinson
Disease starts at an average age of 55-60 years, and the incidence varies
between 15-250/100.000. In Turkish studies, the incidence was indicated as
202/100.000. Primary symptoms of the Parkinson Disease are bradykinesia,
resting tremor, rigidity and postural instability. In addition to these motor
symptoms which occur due to involvement of dopaminergic system,
neuropsychiatric symptoms, autonomic and sleep disturbances, and sensory
symptoms may occur due to the involvement of serotonergic, noradrenergic,
cholinergic and autonomic systems. Posture, balance, gait impairments occur in
patients. Parkinson Disease-specific gait impairments can lead to muscle
weakness, activity limitation, physical inactivity, functional limitations and
negatively affect quality of life. In order to achieve a patient-centered rehabilitation in Parkinson Disease, it
is necessary to target treatment approaches responsive to patient preferences.
Therefore, when assessing perceived difficulty in everyday life, performance-based measures should be complemented with
patient-reported outcome measures. The aim of this study is to review the
literature about the most appropriate patient-reported outcome measures and
performance-based measures to evaluate functional mobility and activity
limitation in individuals with Parkinson Disease, and to light the way for
future clinical and research studies.

Anahtar Kelimeler

Parkinson disease, activities of daily living, mobility limitation, patient-reported outcome measure, gait

Proje Numarası

19/077/07/3/4

Parkinsonlu Bireylerde Fonksiyonel Mobilite ve Aktivite Limitasyonuna Yönelik Hasta Bildirimli ve Performansa Dayalı Sonuç Ölçümleri

Öz

Motor ve motor olmayan semptomlarla karakterize Parkinson hastalığı Alzheimer hastalığından sonra ikinci en
sık görülen nörodejeneratif hastalıktır. Patofizyolojisinde genetik faktörler,
doğumsal anomaliler, toksik ajan maruziyeti, travma, inflamasyon, oksidatif
stres ve beynin derin kısmında yer alan substansiya nigrada dopamin üreten
hücrelerin hasarı yer almaktadır. Parkinson
hastalığı ortalama 55-60 yaşlarında başlamakta, görülme sıklığı 15-250/100.000
arasında değişmektedir. Türkiye'de yapılan çalışmalarda görülme sıklığı
202/100.000 olarak belirtilmiştir. Başlıca belirtileri bradikinezi, istirahat
tremoru, rijidite ve postüral instabilite olan Parkinson
hastalığında serotonerjik, noradrenerjik, kolinerjik ve otonomik sistemin de
etkilenmesi hastada nöropsikiyatrik semptomlara, otonom bozukluklara, uyku
bozukluklarına ve duyusal belirtilere yol açmaktadır. Bu durum postür, denge ve
yürüyüş bozukluklarına neden olmaktadır. Parkinson
hastalığına özgü yürüyüş bozuklukları kas zayıflığı, aktivite limitasyonu,
fiziksel inaktivite ve fonksiyonel açıdan kısıtlılık meydana getirerek
bireylerin yaşam kalitesini olumsuz yönde etkilemektedir. Parkinson hastalığında hasta merkezli rehabilitasyonu
sağlamak için hasta tercihlerine cevap veren tedavi yaklaşımını hedeflemek
gerekir. Bu nedenle günlük yaşam aktivitelerinde algılanan zorlukların değerlendirilmesi aşamasında performansa yönelik ve hasta
bildirimli sonuç ölçümlerinin bir arada ele alınması büyük önem taşımaktadır.
Bu çalışmanın amacı, Parkinsonlu bireylerde aktivite limitasyonu ve fonksiyonel
mobiliteyi değerlendiren en uygun hasta bildirimli sonuç ölçümleri ve
performansa yönelik sonuç ölçümleri ile ilgili literatür bilgisini derlemek ve
ileride yapılacak klinik ve araştırma çalışmalarına ışık tutmaktır. 

Anahtar Kelimeler

Parkinson hastalığı, günlük yaşam aktiviteleri, mobilite limitasyonu, hasta bildirimli sonuç ölçümü, yürüyüş

Destekleyen Kurum

Muğla Sıtkı Koçman Üniversitesi Bilimsel Araştırma Projeleri Koordinasyon Birimi

Proje Numarası

19/077/07/3/4

Teşekkür

Bu çalışma, Muğla Sıtkı Koçman Üniversitesi Bilimsel Araştırma Projeleri Koordinasyon Birimi tarafından desteklenmiştir (Proje no: 19/077/07/3/4, Proje Başlık: Parkinson Hastalığına Sahip Bireylerde Dört Farklı Fonksiyonel Mobilite Testinin Psikometrik Özelliklerinin İncelenmesi).

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