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Christopher G. Goetz - One of the best experts on this subject based on the ideXlab platform.

  • Vibration therapy for Parkinson's disease: Charcot's studies revisited.
    Journal of Parkinson's disease, 2012
    Co-Authors: Sachin S. Kapur, Glenn T. Stebbins, Christopher G. Goetz
    Abstract:

    The 19th century neurologist, J-M Charcot, used a vibration chair for treating Parkinson's disease (PD). He documented improvement, but few subsequent studies examined vibration treatment. Using a specialized lounge chair, we conducted a rater blinded, randomized trial of body vibration vs. no vibration in 23 PD patients. The primary outcome measure was change from baseline in the Motor Section of the MDS-UPDRS. Both vibration and no vibration groups significantly improved after one month of daily treatments. However, there was no significant difference between the two treatment groups, suggesting that non-specific or placebo factors had an effect on PD Motor function.

  • Teaching program for the Movement Disorder Society-sponsored revision of the Unified Parkinson's Disease Rating Scale: (MDS-UPDRS).
    Movement disorders : official journal of the Movement Disorder Society, 2010
    Co-Authors: Christopher G. Goetz, Glenn T. Stebbins, Teresa A. Chmura, Stanley Fahn, Werner Poewe, Caroline M. Tanner
    Abstract:

    To accompany the newly developed Movement Disorder Society revision of the Unified Parkinson's Disease Rating Scale (MDS-UPDRS), we developed a teaching program. The DVD-based program covers the four parts of the scale with visual and verbal instructions for uniform application. For the Motor Section (Part III), all items except rigidity are shown with an example of each rating option (0-4) as agreed upon by a panel of experts. The rate of agreement for the selected samples was always significant, with Kendall's coefficient of concordance W ranging between 0.99 and 0.72. The teaching program also provides a full patient examination with rating answers provided and four full MDS-UPDRS cases for a Certificate Program exercise of Part III. This training program is in English, but as non-English official translations of the MDS-UPDRS are developed, the program can be potentially modified into different languages.

  • Assuring interrater reliability for the UPDRS Motor Section: utility of the UPDRS teaching tape.
    Movement disorders : official journal of the Movement Disorder Society, 2004
    Co-Authors: Christopher G. Goetz, Glenn T. Stebbins
    Abstract:

    We assessed rates of successful certification on the Motor Section of the Unified Parkinson's Disease Rating Scale (UPDRSm) after training with the UPDRS Teaching Tape. The most frequently used clinical scale for PD is the UPDRS, and most clinical trials rely on the Motor examination as the primary outcome measure. Whereas the Movement Disorder Society's UPDRS Teaching Tape has been used widely as a training format, outcome data are lacking. We examined data sets from four multicenter studies that required raters to pass the certification exercise of the UPDRS Teaching Tape. Raters viewed the Teaching Tape showing examples of all rating levels for all items (38 minutes), and then took the certification exercise, rating 4 subjects with PD (20 minutes). Certification required scores on all 4 subjects that fit within the 95% confidence interval range established by three experts. We calculated the numbers of raters successfully certified after one or more rating attempts. Only one-half of 226 raters that participated successfully completed certification on their first attempt, but all completed by the third attempt. North American raters scored better than Europeans raters. The most difficult case to rate was the subject with the least impairment. Standardized methods for training UPDRSm application are essential to ensure that raters use the scale uniformly. Raters have the greatest difficulty with the mildest impairment, making training especially important to studies of early PD.

  • Standardized training tools for the UPDRS activities of daily living scale: Newly available teaching program
    Movement disorders : official journal of the Movement Disorder Society, 2003
    Co-Authors: Christopher G. Goetz, Peter A. Lewitt, Meredith Weidenman
    Abstract:

    The Unified Parkinson's Disease Rating Scale (UPDRS) is the most widely used scale for evaluation of clinical impairment in PD. Whereas the Motor Section has been studied intensively for clinimetric properties and has an associated training tape, the Activities of Daily Living (ADL) Section has been studied less rigorously. In preparation for a multicenter study that planned to use the UPDRS ADL score as an outcome, the authors reviewed the UPDRS ADL scale and designed a teaching program to provide a uniform technique for data acquisition without changing any wording of the primary scale. The teaching program is composed of four components: overall guidelines, clarifying points, recommended strategies, and a teaching videotape. The videotape shows examples of interviewers assessing each ADL item with patients of different disability levels and provides a complete ADL assessment of a single patient. Systematic training and utilization of this teaching program offer the potential for more uniformity in results of ADL assessments conducted in clinical practice and multicenter, international studies of PD. The written materials and videotape belong to the Movement Disorder Society and are available by contacting the MDS central office.

  • Factor analysis of the Motor Section of the unified Parkinson's disease rating scale during the off-state.
    Movement disorders : official journal of the Movement Disorder Society, 1999
    Co-Authors: Glenn T. Stebbins, Christopher G. Goetz, Anthony E. Lang, Esther Cubo
    Abstract:

    Determination of a scale's factor structure requires a two-part process: (1) an initial examination of the factor structure using a sample of individuals with the condition of interest, and (2) repeated examinations of the factor structure using the same analytic methods but applied to independent samples of individuals with the condition of interest who contribute unique variability to the scale measurement. In a previous study, we performed an initial investigation of the factor structure of the Motor Examination Section of the Unified Parkinson's Disease Rating Scale (UPDRS). We used a sample of 294 consecutive patients with idiopathic Parkinson's disease (PD) assessed while in the on-state and identified six clinically distinct factors. In the present study, we performed a confirmatory investigation of the factor structure and analysis of the internal consistency of the UPDRS in a new sample of 200 consecutive PD patients who were assessed while in the off-state. Factor analysis again revealed six factors with identical item loadings as those obtained from examinations of patients in the on-state. Estimates of internal consistency were comparable in the off- and on-state examinations. These results indicate that the Motor Examination Section of the UPDRS has a stable factor structure and high internal consistency across off- and on-state examinations.

Margaret Mak - One of the best experts on this subject based on the ideXlab platform.

  • The effect of transcranial direct current stimulation on upper limb Motor performance in Parkinson’s disease: a systematic review
    Journal of Neurology, 2019
    Co-Authors: Michael William Simpson, Margaret Mak
    Abstract:

    Background and purposeParkinson’s disease (PD) reduces independence and quality of life through deterioration of upper limb Motor function. Transcranial direct current stimulation (tDCS) may offer an alternative, adjunctive therapy for PD. However, the efficacy of tDCS for upper limb Motor rehabilitation in PD is unknown. In this systematic review, evidence is compiled regarding the effects of tDCS on upper limb Motor function in PD.MethodsStudies of tDCS applied to PD patients that assessed upper limb Motor function, conducted between January 2000 and November 2018, were screened for inclusion via a systematic search of Medline, Cochrane, PsycINFO, EMBASE, CINAHL, and Web of Science.ResultsTen out of 606 studies were included and their findings synthesized into five categories regarding the effects of tDCS on: (1) Unified Parkinson’s Disease Rating Scale Motor Section (UPDRS III), (2) upper limb Motor tasks, (3) manual dexterity, (4) reaction time, and (5) neurophysiology.ConclusionsWhen applied to the primary Motor cortex, tDCS may improve UPDRS III and the speed and force of movement. Considerable variation was found in tDCS parameters and further study is needed to clarify the long-term effects of tDCS on both simple and complex Motor tasks and to compile relevant neurophysiological evidence.

Glenn T. Stebbins - One of the best experts on this subject based on the ideXlab platform.

  • Clinimetric Analysis of the Motor Section of the Progressive Supranuclear Palsy Rating Scale: Reliability and Factor Analysis.
    Movement disorders clinical practice, 2015
    Co-Authors: Deborah A. Hall, Glenn T. Stebbins, Irene Litvan, Yvette Bordelon, David E. Riley, James B. Leverenz, David G. Standaert
    Abstract:

    Author(s): Hall, Deborah A; Stebbins, Glenn T; Litvan, Irene; Bordelon, Yvette; Riley, David E; Leverenz, James; Standaert, David G | Abstract: Introduction:PSP is a rare degenerative disorder associated with significant morbidity. Recently, investigations of the etiology and treatment of PSP have been initiated. The aim of the present study was to validate the Motor domain of the Progressive Supranuclear Palsy Rating Scale (PSPRS) as part of a larger epidemiological study. Methods:Fifty videos of patients with PSP were rated by four trained movement disorder neurologists using the PSPRS. Reliability and construct validity of the scale were evaluated using standard methods. Results:Inter-rater reliability for the total scale score was good. Internal consistency of the scale improved with the removal of three items. Four factors accounted for the majority of the variance of the scale as determined by principal components analysis. Discussion:This study shows that the Motor domain of the PSPRS is a reliable scale, with a factor structure that suggests construct validity, for the assessment of Motor signs of the disease. Removal or modification of items may improve the clinimetric features of the Motor domain of the scale.

  • Vibration therapy for Parkinson's disease: Charcot's studies revisited.
    Journal of Parkinson's disease, 2012
    Co-Authors: Sachin S. Kapur, Glenn T. Stebbins, Christopher G. Goetz
    Abstract:

    The 19th century neurologist, J-M Charcot, used a vibration chair for treating Parkinson's disease (PD). He documented improvement, but few subsequent studies examined vibration treatment. Using a specialized lounge chair, we conducted a rater blinded, randomized trial of body vibration vs. no vibration in 23 PD patients. The primary outcome measure was change from baseline in the Motor Section of the MDS-UPDRS. Both vibration and no vibration groups significantly improved after one month of daily treatments. However, there was no significant difference between the two treatment groups, suggesting that non-specific or placebo factors had an effect on PD Motor function.

  • Teaching program for the Movement Disorder Society-sponsored revision of the Unified Parkinson's Disease Rating Scale: (MDS-UPDRS).
    Movement disorders : official journal of the Movement Disorder Society, 2010
    Co-Authors: Christopher G. Goetz, Glenn T. Stebbins, Teresa A. Chmura, Stanley Fahn, Werner Poewe, Caroline M. Tanner
    Abstract:

    To accompany the newly developed Movement Disorder Society revision of the Unified Parkinson's Disease Rating Scale (MDS-UPDRS), we developed a teaching program. The DVD-based program covers the four parts of the scale with visual and verbal instructions for uniform application. For the Motor Section (Part III), all items except rigidity are shown with an example of each rating option (0-4) as agreed upon by a panel of experts. The rate of agreement for the selected samples was always significant, with Kendall's coefficient of concordance W ranging between 0.99 and 0.72. The teaching program also provides a full patient examination with rating answers provided and four full MDS-UPDRS cases for a Certificate Program exercise of Part III. This training program is in English, but as non-English official translations of the MDS-UPDRS are developed, the program can be potentially modified into different languages.

  • Assuring interrater reliability for the UPDRS Motor Section: utility of the UPDRS teaching tape.
    Movement disorders : official journal of the Movement Disorder Society, 2004
    Co-Authors: Christopher G. Goetz, Glenn T. Stebbins
    Abstract:

    We assessed rates of successful certification on the Motor Section of the Unified Parkinson's Disease Rating Scale (UPDRSm) after training with the UPDRS Teaching Tape. The most frequently used clinical scale for PD is the UPDRS, and most clinical trials rely on the Motor examination as the primary outcome measure. Whereas the Movement Disorder Society's UPDRS Teaching Tape has been used widely as a training format, outcome data are lacking. We examined data sets from four multicenter studies that required raters to pass the certification exercise of the UPDRS Teaching Tape. Raters viewed the Teaching Tape showing examples of all rating levels for all items (38 minutes), and then took the certification exercise, rating 4 subjects with PD (20 minutes). Certification required scores on all 4 subjects that fit within the 95% confidence interval range established by three experts. We calculated the numbers of raters successfully certified after one or more rating attempts. Only one-half of 226 raters that participated successfully completed certification on their first attempt, but all completed by the third attempt. North American raters scored better than Europeans raters. The most difficult case to rate was the subject with the least impairment. Standardized methods for training UPDRSm application are essential to ensure that raters use the scale uniformly. Raters have the greatest difficulty with the mildest impairment, making training especially important to studies of early PD.

  • Factor analysis of the Motor Section of the unified Parkinson's disease rating scale during the off-state.
    Movement disorders : official journal of the Movement Disorder Society, 1999
    Co-Authors: Glenn T. Stebbins, Christopher G. Goetz, Anthony E. Lang, Esther Cubo
    Abstract:

    Determination of a scale's factor structure requires a two-part process: (1) an initial examination of the factor structure using a sample of individuals with the condition of interest, and (2) repeated examinations of the factor structure using the same analytic methods but applied to independent samples of individuals with the condition of interest who contribute unique variability to the scale measurement. In a previous study, we performed an initial investigation of the factor structure of the Motor Examination Section of the Unified Parkinson's Disease Rating Scale (UPDRS). We used a sample of 294 consecutive patients with idiopathic Parkinson's disease (PD) assessed while in the on-state and identified six clinically distinct factors. In the present study, we performed a confirmatory investigation of the factor structure and analysis of the internal consistency of the UPDRS in a new sample of 200 consecutive PD patients who were assessed while in the off-state. Factor analysis again revealed six factors with identical item loadings as those obtained from examinations of patients in the on-state. Estimates of internal consistency were comparable in the off- and on-state examinations. These results indicate that the Motor Examination Section of the UPDRS has a stable factor structure and high internal consistency across off- and on-state examinations.

Michael William Simpson - One of the best experts on this subject based on the ideXlab platform.

  • The effect of transcranial direct current stimulation on upper limb Motor performance in Parkinson’s disease: a systematic review
    Journal of Neurology, 2019
    Co-Authors: Michael William Simpson, Margaret Mak
    Abstract:

    Background and purposeParkinson’s disease (PD) reduces independence and quality of life through deterioration of upper limb Motor function. Transcranial direct current stimulation (tDCS) may offer an alternative, adjunctive therapy for PD. However, the efficacy of tDCS for upper limb Motor rehabilitation in PD is unknown. In this systematic review, evidence is compiled regarding the effects of tDCS on upper limb Motor function in PD.MethodsStudies of tDCS applied to PD patients that assessed upper limb Motor function, conducted between January 2000 and November 2018, were screened for inclusion via a systematic search of Medline, Cochrane, PsycINFO, EMBASE, CINAHL, and Web of Science.ResultsTen out of 606 studies were included and their findings synthesized into five categories regarding the effects of tDCS on: (1) Unified Parkinson’s Disease Rating Scale Motor Section (UPDRS III), (2) upper limb Motor tasks, (3) manual dexterity, (4) reaction time, and (5) neurophysiology.ConclusionsWhen applied to the primary Motor cortex, tDCS may improve UPDRS III and the speed and force of movement. Considerable variation was found in tDCS parameters and further study is needed to clarify the long-term effects of tDCS on both simple and complex Motor tasks and to compile relevant neurophysiological evidence.

  • The effect of transcranial direct current stimulation on upper limb Motor performance in Parkinson's disease: a systematic review.
    Journal of neurology, 2019
    Co-Authors: Michael William Simpson, Margaret K.y. Mak
    Abstract:

    Parkinson’s disease (PD) reduces independence and quality of life through deterioration of upper limb Motor function. Transcranial direct current stimulation (tDCS) may offer an alternative, adjunctive therapy for PD. However, the efficacy of tDCS for upper limb Motor rehabilitation in PD is unknown. In this systematic review, evidence is compiled regarding the effects of tDCS on upper limb Motor function in PD. Studies of tDCS applied to PD patients that assessed upper limb Motor function, conducted between January 2000 and November 2018, were screened for inclusion via a systematic search of Medline, Cochrane, PsycINFO, EMBASE, CINAHL, and Web of Science. Ten out of 606 studies were included and their findings synthesized into five categories regarding the effects of tDCS on: (1) Unified Parkinson’s Disease Rating Scale Motor Section (UPDRS III), (2) upper limb Motor tasks, (3) manual dexterity, (4) reaction time, and (5) neurophysiology. When applied to the primary Motor cortex, tDCS may improve UPDRS III and the speed and force of movement. Considerable variation was found in tDCS parameters and further study is needed to clarify the long-term effects of tDCS on both simple and complex Motor tasks and to compile relevant neurophysiological evidence.

Shaimaa Jaafary - One of the best experts on this subject based on the ideXlab platform.

  • rtms for on freezers with advanced pd a long term follow up study s40 001
    Neurology, 2016
    Co-Authors: Hatem S Shehata, Nevi M Shalaby, Mohamed S Eltamawy, Shaimaa Jaafary
    Abstract:

    Objective: Evaluating the long term efficacy and safety of rTMS sessions in management of ‘on-freezing’ and unpredicted offs in advanced Parkinson’s disease (PD). Background:Freezing of gait (FOG) is an independent feature of Parkinson’s disease that is related to both Motor and cognitive deficits. Treatment of off-FOG is relatively straightforward, but ‘on-freezing’ is a difficult-to-treat scenario and it needs a multidisciplinary team approach. Design/Methods:A randomized, double-blind, placebo-controlled study included 43 patients with advanced PD who received 12 sessions of rTMS over 4 weeks (real or sham) every 3 months for a period of 9 months. rTMS (20 trains of 50 stimuli each, at 5 Hz) was delivered over the leg Motor area contralaterally to the more affected side followed by a specific rehabilitation program (60 minutes). Treatments were synchronized with “on-time” to facilitate training sessions. All patients had their daily diary to record ‘on-times’, ‘offs’, ‘falls’, and ‘freezing episodes’. Primary efficacy variables were FOG Q (SF), unpredicted offs and UPDRS (Motor Section), secondary outcomes were on-time and gait variables (cadence, falls number, stride length and turn time). All patients signed a written consent. Results: Freezing episodes significantly decreased (p<0.05) and FOG Q (SF) significantly improved (p<0.001) in the active arm. Attacks of unpredicted offs also decreased significantly (p 0.03), whereas, the Motor Section of UPDRS improved, yet this was statistically non-significant. Number of falls reduced significantly (p<0.001) with improvement of turn time (p 0.04). Other gait variables were not affected. Long-term effects: the effects were maintained over the study period, the doses of dopaminergic drugs were individualized and modified according to the disease progression in both groups. No adverse events were recorded apart from mild transient headaches. Conclusions:rTMS has a positive effect in on-freezers with advanced PD with subsequent decrease of number of falls. Disclosure: Dr. Shehata has nothing to disclose. Dr. Shalaby has nothing to disclose. Dr. El-Tamawy has nothing to disclose. Dr. Jaafary has nothing to disclose.

  • rTMS for On-Freezers with Advanced PD. A Long Term Follow Up Study (S40.001)
    Neurology, 2016
    Co-Authors: Hatem S Shehata, Nevi M Shalaby, Mohamed S. El-tamawy, Shaimaa Jaafary
    Abstract:

    Objective: Evaluating the long term efficacy and safety of rTMS sessions in management of ‘on-freezing’ and unpredicted offs in advanced Parkinson’s disease (PD). Background:Freezing of gait (FOG) is an independent feature of Parkinson’s disease that is related to both Motor and cognitive deficits. Treatment of off-FOG is relatively straightforward, but ‘on-freezing’ is a difficult-to-treat scenario and it needs a multidisciplinary team approach. Design/Methods:A randomized, double-blind, placebo-controlled study included 43 patients with advanced PD who received 12 sessions of rTMS over 4 weeks (real or sham) every 3 months for a period of 9 months. rTMS (20 trains of 50 stimuli each, at 5 Hz) was delivered over the leg Motor area contralaterally to the more affected side followed by a specific rehabilitation program (60 minutes). Treatments were synchronized with “on-time” to facilitate training sessions. All patients had their daily diary to record ‘on-times’, ‘offs’, ‘falls’, and ‘freezing episodes’. Primary efficacy variables were FOG Q (SF), unpredicted offs and UPDRS (Motor Section), secondary outcomes were on-time and gait variables (cadence, falls number, stride length and turn time). All patients signed a written consent. Results: Freezing episodes significantly decreased (p