Dataset Information

Psychomotor processing and functional decline in Parkinson's disease predicted by the Purdue Pegboard test.

ABSTRACT:

Background

The Purdue Pegboard test (PPT) assesses upper-extremity dexterity and motor skills. We hypothesized that PPT skill would predict functional and cognitive decline in Parkinson's disease (PD), independent of observer-rated measures of motor impairment.

Methods

We utilized data from 399 PD participants enrolled in the deprenyl and tocopherol antioxidative therapy of Parkinsonism trial. Unified Parkinson Disease Rating Scale (UPDRS) metrics, neuropsychological assessments, and clinical rating scales were extracted for analysis with multivariate linear mixed-effects and generalized estimating equation regression models.

Results

In multivariate logistic regression, higher baseline and time-varying PPT scores predicted better visual processing speed and attention throughout longitudinal follow-up. No similarly strong associations were found for tests of memory, nonvisual attention, phonemic fluency, or set-shifting. Independently of observer-rated motor impairment (UPDRS part III), PPT performance was significantly associated with changes in activities of daily living (ADL) function measured with UPDRS part II. Low baseline PPT score (≤10th percentile) doubled the relative risk of later ADL dysfunction (≥90th percentile).

Conclusions

PPT impairment selectively predicted declining psychomotor processing speed in PD. The domain-specificity of this association may reflect correlated pathophysiological changes in top-down visual and motor control pathways. PPT also predicted increasing ADL dysfunction after adjusting for objective measures of motor impairment. We suggest that PPT scores may be prognostically useful for predicting cognitive changes and ADL dysfunction, which have dramatic impacts on both patient and caregiver quality of life. Furthermore, simple task-based assessments like the PPT could be investigated for remote assessment in PD.

SUBMITTER: Hinkle JT

PROVIDER: S-EPMC8102321 | biostudies-literature | 2021 Jun

REPOSITORIES: biostudies-literature

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Publications

Psychomotor processing and functional decline in Parkinson's disease predicted by the Purdue Pegboard test.

Hinkle Jared T JT Pontone Gregory M GM

International journal of geriatric psychiatry 20210202 6

<h4>Background</h4>The Purdue Pegboard test (PPT) assesses upper-extremity dexterity and motor skills. We hypothesized that PPT skill would predict functional and cognitive decline in Parkinson's disease (PD), independent of observer-rated measures of motor impairment.<h4>Methods</h4>We utilized data from 399 PD participants enrolled in the deprenyl and tocopherol antioxidative therapy of Parkinsonism trial. Unified Parkinson Disease Rating Scale (UPDRS) metrics, neuropsychological assessments, ...[more]

PMID: 33426751

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Project description:Background/Objectives: Parkinson's disease (PD) is a neurodegenerative disorder that significantly impairs motor function, leading to mobility challenges and an increased risk of falls. Current assessment tools often inadequately measure the complexities of motor impairments associated with PD, highlighting the need for a reliable tool. This study introduces the Motor Assessment Timed Test (MATT), designed to assess functional mobility in PD patients. Methods: A cross-sectional study was conducted involving 57 participants (38 men and 19 women) aged 44 to 84, diagnosed with idiopathic PD. Participants were recruited from three PD associations and underwent a series of assessments, including MATT, to evaluate gait, balance, and dual-task performance under conditions that reflect real-life challenges faced by individuals with PD. Results: MATT demonstrated excellent reliability with intra-rater reliability (ICC = 0.99), inter-rater reliability (ICC = 0.96-0.99), and test-retest reliability (ICC = 0.93-0.99). The coefficient of variation for total time and each segment ranged from 4.73% to 13.71%, indicating consistent performance across trials. The concurrent validity showed very high correlations with established tools such as the Timed Up and Go (TUG) test (ρ = 0.86, p < 0.001) and the Berg Balance Scale (BBS) (ρ = -0.83, p < 0.001), among others. Only 7.3% of participants reported difficulties in understanding the MATT, predominantly those in advanced stages of the disease. In addition, 23.6% of participants experienced significant challenges in performing the test, particularly individuals with lower Mini-Mental State Examination (MMSE) scores (≤ 26) and more advanced disease progression. Conclusions: MATT is a promising tool for assessing motor complications in PD, offering a comprehensive evaluation of functional mobility. Its implementation in clinical practice could enhance the management of PD, facilitating tailored interventions and improving patient outcomes.

Project description:AimThe aims of this study were twofold: first, to develop and validate a timed test of unimanual and bimanual dexterity suitable for those with disability affecting hand function; second, to explore relationships between unimanual and bimanual completion times.MethodWe developed the Tyneside Pegboard Test (TPT), an electronically timed test with three peg sizes, incorporating an asymmetrical bimanual task. Nine hundred and seventy-four participants (455 males, 519 females; age range 4-80y) provided normative data. Test-retest reliability and construct validity were assessed (50 adults: 14 males, 36 females; 15-73y) on two occasions 2 weeks apart. Bimanual and unimanual completion times were measured in 87 children (51 males, 36 females) with unilateral cerebral palsy (CP) and 498 individuals in a comparison group (238 males, 260 females; 5-15y).ResultsThe comparison group showed an asymmetrical U-shaped relationship between completion times and age. Intraclass correlation coefficients ranged from 0.74 to 0.91, indicating moderate test-retest reliability. There was a negative relationship between average TPT bimanual times and Purdue pegboard bimanual scores (Spearman's rho -0.611, degrees of freedom 44, p<0.001). Children with unilateral CP had greater prolongation of bimanual than unimanual completion times compared with the comparison group (mean difference 20.31s, 95% confidence interval 18.13-22.49, p<0.001).InterpretationThe TPT is accessible for those with impaired hand function. Children with unilateral CP demonstrated disproportionate bimanual deficits, even allowing for unimanual dexterity: this has implications for therapy.What this paper addsWe developed an adapted, electronically timed 9-hole pegboard test. Our modifications facilitate use by those with disability affecting hand function. The test incorporates an asymmetrical bimanual task. Children with unilateral cerebral palsy showed disproportionate bimanual dexterity deficits even allowing for unimanual dexterity.

Dataset Information

Psychomotor processing and functional decline in Parkinson's disease predicted by the Purdue Pegboard test.

Background

Methods

Results

Conclusions

Publications

Psychomotor processing and functional decline in Parkinson's disease predicted by the Purdue Pegboard test.

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