The clinical evaluation includes a modified version of the motor portion of the Unified Parkinson's Disease Rating Scale (modified UPDRS) which is used to assess four parkinsonian domains including bradykinesia, rigidity, parkinsonian gait, and tremor, in addition to a composite global measure of parkinsonism [40 (link)].
Upper and lower extremity motor strength and performance tests were collected as previously described [57 ]. These include grip and pinch strength measured by hydraulic dynamometers, arm abduction, arm flexion, arm extension, hip flexion, knee extension, plantar flexion, and ankle dorsiflexion measured with handheld dynamometry; time and number of steps to walk 2.4 meters and to turn 360°; participants were asked to stand on each leg and then on their toes for 10 seconds. We record number of steps off the line when walking 8 feet (2.4 meters) heel-to-toe; and Purdue pegboard and finger tapping. A composite measure of global motor function was constructed by converting the raw score from each of the motor measures to z scores using the mean (SD) from all participants at baseline and averaging. Separate summary measures of strength and performance were also developed.
A continuous composite measure of physical frailty was developed based on the four commonly used components of frailty, as previously described [58 (link)]. These include grip strength, timed 2.4 meter walk, body mass index based on measured height and weight, and fatigue based on two questions from the Center for Epidemiologic Studies-Depression Scale (CES-D). A dichotomous version was also developed for analyses.
Upper and lower extremity motor strength and performance tests were collected as previously described [57 ]. These include grip and pinch strength measured by hydraulic dynamometers, arm abduction, arm flexion, arm extension, hip flexion, knee extension, plantar flexion, and ankle dorsiflexion measured with handheld dynamometry; time and number of steps to walk 2.4 meters and to turn 360°; participants were asked to stand on each leg and then on their toes for 10 seconds. We record number of steps off the line when walking 8 feet (2.4 meters) heel-to-toe; and Purdue pegboard and finger tapping. A composite measure of global motor function was constructed by converting the raw score from each of the motor measures to z scores using the mean (SD) from all participants at baseline and averaging. Separate summary measures of strength and performance were also developed.
A continuous composite measure of physical frailty was developed based on the four commonly used components of frailty, as previously described [58 (link)]. These include grip strength, timed 2.4 meter walk, body mass index based on measured height and weight, and fatigue based on two questions from the Center for Epidemiologic Studies-Depression Scale (CES-D). A dichotomous version was also developed for analyses.
