Roongroj Bhidayasiri1, Onanong Phokaewvarangkul2, Jirada Sringean2, Pablo Martinez-Martin3, Chanawat Anan2, Nitinan Kantachadvanich2, K Ray Chaudhuri4, Nobutaka Hattori5. 1. Chulalongkorn Center of Excellence for Parkinson's Disease & Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, 10330, Thailand; Department of Neurology, Juntendo University, Tokyo, Japan. Electronic address: rbh@chulapd.org. 2. Chulalongkorn Center of Excellence for Parkinson's Disease & Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, 10330, Thailand. 3. National Centre of Epidemiology and CIBERNAD, Carlos III Institute of Health, Madrid, Spain. 4. National Parkinson Foundation Centre of Excellence, King's College Hospital, London, UK. 5. Department of Neurology, Juntendo University, Tokyo, Japan.
Abstract
BACKGROUND: Nocturnal hypokinesia is a decreased ability to perform sufficient axial rotation and/or trunk flexion to turn in or get out of bed. Currently, there are no validated questionnaires specifically to assess nocturnal hypokinesia in PD patients. OBJECTIVE: To develop and validate a questionnaire to assess PD patients' problems associated with turning or getting out of bed. METHODS: The nocturnal hypokinesia questionnaire (NHQ) consists of 10 items, completed independently by patients and their caregivers. For validation, 76 patient-caregiver pairs completed the questionnaire and validity, agreement levels, and internal consistency assessed. In addition, 76 healthy couples served as controls. The NHQ and Modified Parkinson's Disease Sleep Scale (PDSS-2) were compared and 25 random patients-caregiver pairs were also assessed with objective night-time monitoring. RESULTS: Patient and caregiver scores showed a high level of agreement (Intra-class correlation: 0.84) with high internal consistency (KR-20 coefficient of 0.73 for patients and 0.69 for caregivers). No significant difference between the mean total NHQ scores as rated by patients and caregivers was observed. Mean NHQ scores from patients and caregivers were significantly higher than healthy controls (p < 0.001). Moderate correlations were found between the NHQ and PDSS-2 (r = 0.32, p = 0.004), and with objective monitoring (Number of turns: r = -0.41, p = 0.04, Degree of turn: r = -0.44, p = 0.02). CONCLUSION: The NHQ is a reliable instrument to identify symptoms of nocturnal hypokinesia amongst PD patients. Strong patient-caregiver agreement supports the use of proxy evaluation by caregivers when patient's information is unobtainable.
BACKGROUND:Nocturnal hypokinesia is a decreased ability to perform sufficient axial rotation and/or trunk flexion to turn in or get out of bed. Currently, there are no validated questionnaires specifically to assess nocturnal hypokinesia in PDpatients. OBJECTIVE: To develop and validate a questionnaire to assess PDpatients' problems associated with turning or getting out of bed. METHODS: The nocturnal hypokinesia questionnaire (NHQ) consists of 10 items, completed independently by patients and their caregivers. For validation, 76 patient-caregiver pairs completed the questionnaire and validity, agreement levels, and internal consistency assessed. In addition, 76 healthy couples served as controls. The NHQ and Modified Parkinson's Disease Sleep Scale (PDSS-2) were compared and 25 random patients-caregiver pairs were also assessed with objective night-time monitoring. RESULTS:Patient and caregiver scores showed a high level of agreement (Intra-class correlation: 0.84) with high internal consistency (KR-20 coefficient of 0.73 for patients and 0.69 for caregivers). No significant difference between the mean total NHQ scores as rated by patients and caregivers was observed. Mean NHQ scores from patients and caregivers were significantly higher than healthy controls (p < 0.001). Moderate correlations were found between the NHQ and PDSS-2 (r = 0.32, p = 0.004), and with objective monitoring (Number of turns: r = -0.41, p = 0.04, Degree of turn: r = -0.44, p = 0.02). CONCLUSION: The NHQ is a reliable instrument to identify symptoms of nocturnal hypokinesia amongst PDpatients. Strong patient-caregiver agreement supports the use of proxy evaluation by caregivers when patient's information is unobtainable.
Authors: K Ray Chaudhuri; Anette Schrag; Daniel Weintraub; Alexandra Rizos; Carmen Rodriguez-Blazquez; Eugenia Mamikonyan; Pablo Martinez-Martin Journal: Mov Disord Date: 2019-09-30 Impact factor: 10.338