Percorrer por autor "Abreu, Daisy"
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- Cross-cultural adaptation and validation of the swallowing disturbance questionnaire and the sialorrhea clinical scale in portuguese patients with Parkinson’s diseasePublication . Cardoso, Rita; Guimarães, Isabel; Santos, Helena; Carvalho, Joana; Abreu, Daisy; Gonçalves, Nilza; Ferreira, JoaquimIntroduction: To date, no valid outcome measure has been developed in European Portuguese (EP) to evaluate the Parkinsons’ Disease (PD) patients’ (PwP) reports regarding their swallowing disturbances. Objectives: The aim of this study was to translate and cross-culturally adapt the Swallowing Disturbance Questionnaire (SDQ) and the Sialorrhea Clinical Scale for PD (SCS-PD) into EP and to determine its clinimetric properties in PwP. Materials and Methods: The original English SDQ and SCS-PD versions were cross-culturally adapted following recommendations established in international guidelines. The validation process involved 75 PwP and 65 healthy sex- and age-matched participants. Results: The EP versions of the SDQ and SCS-PD are equivalent to the original versions (content, depth, and scoring). Statistical analyses for the SDQ tool revealed good feasibility (missing data <5%), acceptability (no floor or ceiling effects), excellent internal consistency (Cronbach's = 0.95), good construct validity (78.5% revealed large to moderate loadings), moderate convergent validity (r = 0.60), good divergent validity (r = 0.40), good known-groups validity (p-value<.05) and a fair sensitivity and specificity (AUC = 0.700). Statistical analyses for the SCS-PD tool shows good feasibility, reasonable acceptability (floor effect), good internal consistency (Cronbach's a¼0.85), good construct validity (85.7% showed between large to moderate loadings), good convergent validity (r = 0.78), good divergent validity (r = 0.39), good known groups validity (p-value < .05) and a fair sensitivity and specificity (AUC = 0.704). Conclusions: The EP versions of the SDQ and SCS-PD maintained the characteristics of the original versions and therefore consistent tools to be used in PwP.
- Disability in activities of daily living and severity of dyskinesias determine the handicap of Parkinson´s disease patients in advanced stage selected to dbsPublication . Coelho, Miguel; Abreu, Daisy; Correia-Guedes, Leonor; Lobo, Patrícia Pita; Fabbri, Margherita; Godinho, Catarina; Domingos, Josefa; Albuquerque, Luisa; Freitas, Vanda; Pereira, João Miguel; Cattoni, Begona; Carvalho, Herculano; Reimão, Sofia; Rosa, Mário M.; Ferreira, António Gonçalves; Ferreira, Joaquim J."BACKGROUND: There is scarce data on the level of handicap in Parkinson's disease (PD) and none in advanced stage PD. OBJECTIVE: To assess the handicap in advanced stage PD patients with disabling levodopa-induced motor complications selected to deep brain stimulation (DBS). METHODS: Data was prospectively recorded during routine evaluation for DBS. Handicap was measured using London Handicap Scale (LHS) (0 = maximal handicap; 1 = no handicap). Disease severity was evaluated using the Hoehn & Yahr scale and the UPDRS/MDS-UPDRS, during off and on after a supra-maximal dose of levodopa. Schwab and England Scale (S&E) was scored in off and on. Dyskinesias were scored using the modified Abnormal Involuntary Movement Scale (mAIMS). Results concern cross-sectional assessment before DBS. RESULTS: 100 PD patients (mean age 61 (±7.6); mean disease duration 12.20 (±4.6) years) were included. Median score of motor MDS-UPDRS was 54 in off and 25 in on. Mean total LHS score was 0.56 (±0.14). Patients were handicapped in several domains with a wide range of severity. Physical Independence and Social Integration were the most affected domains. Determinants of total LHS score were MDS-UPDRS part II off (β= -0.271; p = 0.020), S&E on (β= 0.264; p = 0.005) and off (β= 0.226; p = 0.020), and mAIMS on (β= -0.183; p = 0.042) scores (R2 = 29.6%). CONCLUSIONS: We were able to use handicap to measure overall health condition in advanced stage PD. Patients were moderately to highly handicapped and this was strongly determined by disability in ADL and dyskinesias. Change in handicap may be a good patient-centred outcome to assess efficiency of DBS."
- Dysphagia predicts poor outcome in late-stage Parkinson's diseasePublication . Fabbri, Margherita; Coelho, Miguel; Abreu, Daisy; Guedes, Leonor Correia; Rosa, Mario M.; Godinho, Catarina; Cardoso, Rita; Guimarães, Isabel; Antonini, Angelo; Zibetti, Maurizio; Lopiano, Leonardo; Ferreira, Joaquim J."BACKGROUND: Few data exist on the rate of clinical progression for Parkinson's disease (PD) patients who have entered a late stage of the disease. OBJECTIVE: Study the clinical progression of a late-stage PD (LSPD) population over one year follow-up. METHODS: 50 LSPD patients (Schwab and England ADL Scale <50 or Hoehn Yahr Stage >3 in MED ON) underwent an extensive clinical assessment at baseline and after one year and an acute levodopa test at baseline. RESULTS: Mean age of LSPD patients (female 46%) was 77.5 ± 5.9 years and mean disease duration was 15.5 ± 6.5 years. At baseline, 76% had levodopa-induced motor complications (MC), usually non-troublesome, 68% were demented, 54% had psychosis and 68% depression. Caregiver distress was high. l-dopa responsiveness was mild (18% ± 12 of improvement on MDS-UPDRS-III). After one-year, 20% of the patients were dead, institutionalized or HY 5. MDS-UPDRS-motor mean score worsened 7.2 ± 10.3 points although there was heterogeneity between patients, and there was a global worsening of non-motor symptoms, mostly in cognition/mood, urinary and gastrointestinal domains. Nevertheless, MC improved despite similar levodopa equivalent dose. Functional independence and quality of life worsened. Dysphagia severity at baseline predicted a poor outcome (death, institutionalization or HY 5) (Hazard ratio 2.3, 95% CI 1.12-4.4; p = 0.01), whereas magnitude of l-dopa response of LSPD patients did not. CONCLUSIONS: LSPD patients still present a significant, although heterogeneous, motor and non-motor progression over 1 year. Dysphagia severity predicts the occurrence of additional disease severity milestones and its management must be prioritized."
- Dysphagia predicts poor outcome in late-stage Parkinson's diseasePublication . Fabbri, Margherita; Coelho, Miguel; Abreu, Daisy; Guedes, Leonor Correia; Rosa, Mario M; Godinho, Catarina; Cardoso, Rita; Guimarães, Isabel; Antonini, Angelo; Zibetti, Maurizio; Lopiano, Leonardo; Ferreira, Joaquim J
- Frenchay dysarthria assessment (FDA-2) in Parkinson’s disease: cross-cultural adaptation and psychometric properties of the european portuguese versionPublication . Cardoso, Rita; Guimarães, Isabel; Santos, Helena; Loureiro, Rita; Domingos, Josefa; Abreu, Daisy; Gonçalves, Nilza; Pinto, Serge; Ferreira, JoaquimHypokinetic dysarthria is a common symptom in those with Parkinson’s disease (PD); there is currently no standardized or validated tool for assessing speech in this population. To translate into European Portuguese (EP) the FDA-2 and perform a cultural adaptation followed by an evaluation of its psychometric properties in PD in a sample of people with PD in different stages of disease progression. Translation, back-translation, experts’ analysis, pretest and final version test were performed. The EP version of the FDA-2 was administered to 80 people with PD (PwP) with dysarthria, feasibility and acceptability, reliability (internal consistency and inter-rater reliability) and validity (face and convergent) were measured. Overall, the EP-FDA-2 proved to be similar to the original demonstrating the same conceptual meanings, semantics, idiomatic and score equivalences. It has good feasibility (missing data\5 %), acceptability (ceiling and floor effects \15 %), a high reliability of the total score (0.94), an excellent inter-rater agreement for the total score (0.96) and moderate to large construct validity for 81 % of its items. It is well correlated with the gold standard for disease severity assessment in PD, the MDS-UPDRS. The EPFDA- 2 has shown the salient features of a valid tool that can be used by speech and language therapists in the assessment of dysarthria in PD in clinical practice as in the research field.
- Neuromelanin magnetic resonance imaging of the Substantia Nigra in LRRK2-related Parkinson’s DiseasePublication . Guedes, Leonor Correia; Reimão, Sofia; Paulino, Patrícia; Nunes, Rita G.; Bouça-Machado, Raquel; Abreu, Daisy; Gonçalves, Nilza; Soares, Tiago; Fabbri, Margherita; Godinho, Catarina; Lobo, Patrícia Pita; Neutel, Dulce; Quadri, Marialuisa; Coelho, Miguel; Rosa, Mário M.; Campos, Jorge; Outeiro, Tiago; Sampaio, Cristina; Bonifati, Vincenzo; Ferreira, Joaquim J.
- Predictors of drooling severity in people with Parkinson’s diseasePublication . Nascimento, David; Meira, Bruna; Garcez, Luís; Abreu, Daisy; Outeiro, Tiago; Guimarães, Isabel; Ferreira, Joaquim J.Background Drooling, defned as the unintentional loss of saliva from the anterior oral cavity, remains poorly understood in terms of the underlying clinical factors in people with Parkinson’s disease (PwP). This study aims to clarify these factors by analyzing predictors and secondarily the correlates with the severity of drooling in PwP. Methods We conducted a cross-sectional study involving 42 PwP with drooling and 59 without drooling. Clinical assess ments were performed, and the primary outcome was the item 2.2 Saliva and drooling of the Movement Disorder Society Unifed Parkinson’s Disease Rating Scale. The Mann–Whitney test was used to compare the distribution diferences in clinical variables between PwP with and without drooling. The Spearman test was used to examine correlations with drooling, and ordinal logistic regression was used to examine predictors of drooling. Results PwP with drooling showed signifcantly greater impairments in axial signs, posture, facial expression, speech, swallowing, oromotor, motor and non-motor domains than PwP without drooling. Longer disease duration, higher disease severity, levodopa equivalent daily dose, axial signs, unstimulated salivary fow rate, and impairments in speech, posture, facial expression, swallowing, oromotor, motor and non-motor domains were signifcantly correlated with a higher score on the item 2.2. Male sex, poorer swallowing, oromotor and speech functions were strong predictors of higher scores on the item 2.2 Saliva and drooling. Conclusions Male PwP with swallowing disorders, oromotor and speech impairments are signifcantly more likely to have severe drooling. Targeted interventions aimed at these swallowing, oromotor, and speech impairments may ofer promising approaches to reducing drooling severity in PwP.
- Psychosocial impact of Parkinson’s disease-associated dysarthria: cross-cultural adaptation and validation of the Dysarthria Impact Profile into european portuguesePublication . Cardoso, Rita; Guimarães, Isabel; Santos, Helena; Loureiro, Rita; Domingos, Josefa; Abreu, Daisy; Gonçalves, Nilza; Pinto, Serge; Ferreira, JoaquimAim: The present study sought to make a cross-cultural adaptation of the Dysarthria Impact Profile (DIP) for European Portuguese (EP) and validate it for use in Parkinson’s disease (PD) patients. Methods: The cross-cultural adaptation was carried out in accordance with the guidelines. The EP version of the DIP was administered to 80 people with PD, and 30 sex- and age-matched control participants. Psychometric properties, acceptability, feasibility reliability (internal consistency and intrarater agreement) and validity (construct, convergent and known-groups validity) were assessed using other assessment tools (motor disability and impairment, and voice impact). Results: Overall, the EP-DIP final version has the same conceptual meaning, semantics, idiomatic and score equivalences as the original version. Statistical analyses showed adequate feasibility (missing data <5%), good acceptability (ceiling or floor effects <15%; high requests of assistance to complete the questionnaire), satisfactory internal consistency (Cronbach’s α = 0.9), weak-to-moderate intrarater reliability, good construct validity, strong convergent validity (with the Voice Handicap Index; Spearman’s P = −0.8) and good known-groups validity (between those with PD and control participants). Conclusions: The EP-DIP version displays the salient features of a valid patient-based assessment tool used to measure the psychosocial impact of slight-to-mild dysarthria in people with PD.
- Quantitative home-based assessment of Parkinson´s symptoms: The SENSE-PARK feasibility and usability studyPublication . Ferreira, Joaquim J.; Godinho, Catarina; Santos, Ana T.; Domingos, Josefa; Abreu, Daisy; Gonçalves, Nilza; Barra, Marcio; Larsen, Frank; Fagerbakke, Oyvind; Akeren, Ingvild; Wangen, Hilde; Serrano, Artur; Weber, Peter; Thoms, Andrea; Meckler, Stefan; Sollinger, Stefan; Van Uem, Janet; Hobert, A.; Maier, Katrin S.; Matthew, Helen; Isaacs, Tom; Duffen, Joy; Graessner, Holm; Maetzler, Walter"Background: Currently, assessment of symptoms associated with Parkinson’s disease is mainly performed in the clinic. However, these assessments have limitations because they provide only a snapshot of the condition. Methods: The feasibility and usability of an objective, continuous and relatively unobtrusive system (SENSE-PARK System), which consists of wearable sensors (three worn during the day and one worn at night), a smartphone-based App, a balance board and computer software, was tested 24/7 over 12 weeks in a study including 22 PD patients. During the first four weeks of the study, patients did not get feedback about their performance, during the last eight weeks they did. The study included seven clinical visits with standardized interviews, and regular phone contact. The primary outcome was the number of drop-outs during the study. As secondary outcomes, the Post-Study System Usability Questionnaire (PSSUQ), score and information obtained from the standardized interviews were used to evaluate the usability of the system. Results: All patients completed the study. The participants rated the usability of the SENSE-PARK System with a mean score of 2.67 (±0.49) on the PSSUQ. The interviews revealed that most participants liked using the system and appreciated that it signaled changes in their health condition. Conclusions: This 12 week controlled study demonstrates that the acceptance level of PD patients using the SENSE-PARK System as a home-based 24/7 assessment is very good. Particular emphasis should be given to a user-friendly design. Motivation to wear such a system can be increased by providing direct feedback about the individual health condition."
- Quantitative home-based assessment of Parkinson`s symptoms: The SENSE-PARK feasibility and usability studyPublication . Ferreira, Joaquim J.; Godinho, Catarina; Santos, Ana T.; Domingos, Josefa; Abreu, Daisy; Gonçalves, Nilza; Barra, Marcio; Larsen, Frank; Fagerbakke, Oyvind; Akeren, Ingvild; Wangen, Hilde; Serrano, Artur; Weber, Peter; Thoms, Andrea; Meckler, Stefan; Sollinger, Stefan; Van Uem, Janet; Hobert, Markus A.; Maier, Katrin S.; Matthew, Helen; Isaacs, Tom; Duffen, Joy; Graessner, Holm; Maetzler, Walter