Summary

Parkinson’s Disease is a progressive neurological disorder that affects movement. The nerve cells that produce Dopamine begin to break down and die which can cause tremors and the inability to initiate or cease movement. There is no cure for Parkinson’s Disease, and individuals move through the progression of disability by Hoehn and Yahr presented in the list below. The Hoehn and Yahr stages are utilized in the Neuro PT EDGE recommendations when distinguishing between different severity levels in individuals with PD.

• 1.0 : Unilateral involvement only

• 1.5 : Unilateral and axial involvement

• 2.0 : Bilateral involvement without impairment of balance

• 2.5 : Mild bilateral involvement with recovery on retropulsion test

• 3.0 : Mild to moderate bilateral involvement, some postural instability but physically independent

• 4.0 : Severe disability; still able to walk and to stand unassisted

• 5.0 : Wheelchair bound or bedridden unless aided

Recommendations for the outcome measures presented below were categorized by acuity level, disability level (Hoehn and Yahr stages), and those recommended for entry-level PT education. Recommendations for entry-level PT education include two sub-categories: students should learn to use and students should be exposed to. The following list explains the rating scale used by the PD Taskforce.

• 4 : highly recommend - excellent psychometrics in PD population and excellent clinical utility in PD population.

• 3 : recommend - good psychometrics in PD population and good clinical utility in the PD population.

• 2 : unable to recommend at this time; good or excellent psychometric data demonstrated in at least one population, but insufficient study in target population and good clinical utility

• 1 : do not recommend - poor psychometrics and/or limited clinical utility

Outcome Measures

Looking at neurologic diagnoses, the Academy of Neurologic Physical Therapy (ANPT) has developed recommendations for the use of outcome measures in clinical practice and research. The Academy has also developed reference pages for the outcome measures that must be learned throughout a 3-year DPT program. Parkinson's Disease specific psychometrics for the core outcome measures can be found on the home page under each link. The outcome measures listed below are recommended tests that entry-level physical therapists should be able to administer with the Parkinson's population specifically. These were reviewed by NeuroPT EDGE and were found to be useful for the PD population. There are other outcome measures on this document that are supported for use with the PD population; however, they were not categorized as entry-level.

Parkinson EDGE Outcome Measures Summary

Parkinson EDGE Complete Document of Recommendations

Parkinson Clinical Practice Guidelines