Two Tools Recommended for ADL Assessment in Patients With Parkinson Disease

Among tools most frequently used in studies to assess activities of daily living (ADL) in patients with Parkinson disease, only 2 classified for “recommended” status: the Movement Disorder Society Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) and the Schwab & England ADL scale (S&E scale). Researchers reported their findings in Frontiers in Neuroscience.

“Even though ADL is a relevant topic and a common outcome in Parkinson disease clinical studies, the best measurement instruments for assessing ADL in Parkinson disease patients are unknown,” wrote researchers. “As a result, we conducted a systematic review of the published literature to identify and critically evaluate the measurement instruments used to assess ADL.”

The review, which included 129 observational and experimental studies, identified 37 measurement instruments used to assess ADL in patients with Parkinson disease. The most frequently cited instruments were the S&E scale, the MDS-UPDRS, the Unified Parkinson’s Disease Rating Scale, the Barthel Index, the Lawton-Brody Instrumental Activities of Daily Living Scale, the Functional Independence Measure, and the Alzheimer’s Disease Cooperative Study-ADL scale.

After assessing the clinimetric properties of each instrument, the authors reported that only the MDS-UPDRS and the S&E scale achieved the study’s highest level of classification, “recommended.”

“The full MDS-UPDRS can provide a more comprehensive perspective of patients’ ability to perform ADL, however, it is time-consuming to use in clinical routine,” wrote study authors. “To overcome this difficulty, the MDS-UPDRS Part II, which focuses on ADL and assesses it through a self-administered questionnaire, can be used as an independent measurement instrument.”

When a more global perspective of a patient’s independence in performing ADLs is needed, the S&E scale is best, they added.

“Future studies should explore the use of wearable devices to assess ADL remotely and more continuously,” concluded study authors.

Reference:
Bouça-Machado R, Fernandes A, Ranzato C, Beneby D, Nzwalo H, Ferreira JJ. Measurement tools to assess activities of daily living in patients with Parkinson’s disease: a systematic review. Front Neurosci. 2022;16:945398. doi:10.3389/fnins.2022.945398