Dados do Trabalho

Título

Assessment of upper limbs impairments in Parkinson's disease: a systematic review

Resumo

Progressive reduction of upper limbs functional capacity is common in Parkinson's disease (PD). In addition, upper limb freezing (FOUL) episodes can be very disabling during daily life activities. Only a few tests for assessing upper limbs (UL) in PD are available. And a standard upper limbs functional capacity assessment in PD is unknown.
Objective: To identify the frequent outcomes measurements to assess UL functional capacity in PD.
Methods: We reviewed systematically the literature published from February 2010 to February 2021 according to PRISMA guidelines. We analyzed only published studies in English from a systematic review in PubMed, using the following keywords: "upper limbs" OR “upper extremity” and “functional capacity” and "Parkinson’s disease"[All Fields])). [MeSH Terms]). This study was registered at PROSPERO CRD 42021254486.
Results: We found initially a total of 408 studies, 396 in PubMed and 12 in other sources. According to the inclusion and exclusion criteria, 40 studies published in English were included in this review. All quantitative study designs, including systematic reviews published from February 2010 were also included in this review. Studies that don't mention PD and that don't present UL assessments were excluded. No studies were found to assess UL functional capacity in PD. The most common upper limbs outcome measures found in the studies were: (i) to assess severity and progression of PD motor symptoms (tremor and bradykinesia): UPDRS-III (n=17), MDS-UPDRS (n=14), NFOG-Q (n=6), Nine Hole Peg Test (n=5), MOCA (n=4), Purdue Pegboard Test (n=4), Fahn-Tolosa-Marin Tremor Rating Scale (n=2); (ii) to assess manual dexterity: Nine Hole Peg Test (n=5) and Purdue Pegboard Test (n=4); (iii) to provoke and assess FOUL Spiral test (n=2) Funnel test (n=2); (iv) Use of technology such as sensors (n=3), app or digital platform (n=3).
Discussion: Currently, physiotherapy guidelines for PD provide no standard recommendations to assess UL functional capacity. Only a few studies have shown that it is possible to assess tremors, bradykinesia, and manual dexterity. There is a lack of a standard UL functional capacity assessment. FOUL can be objectively assessed by evaluating the spiral-drawing or funnel tasks, but only a few studies reported these assessments.
Conclusion: Current evidence is insufficient to recommend standard and effective outcome measures to assess upper limb functional capacity in PD. Further research is needed.