Characterization and Validation of the Short Physical Performance Battery in Individuals Diagnosed With Parkinson's Disease

Ad Hoc Sociodemographic and Clinical Data Collection Form

An individual case report form was developed to collect the following participant characteristics and clinical data separately: age (years), sex (male/female), time since Parkinson's disease diagnosis (years, calculated from the date of diagnosis), Hoehn and Yahr stage (stage 1-5), comorbidities (presence and type), Parkinson's disease-specific pharmacological treatment (type and route of administration), disease-specific interventions such as deep brain stimulation (presence/absence and type), and physiotherapy treatment (type and frequency).

Time frame: Baseline

Movement Disorder Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS) (Goetz et al., 2008)

The Movement Disorder Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS) is a validated scale assessing Parkinson's disease (PD) severity and progression. It evaluates motor and non-motor symptoms. Total scores range from 0 to 272, with higher scores indicating greater disease severity and worse outcomes. The scale has four parts: Part I assesses non-motor experiences of daily living; Part II assesses motor experiences of daily living; Part III is a clinician-administered motor examination assessing rigidity, bradykinesia, gait, posture, balance, and tremor in relation to medication status (ON/OFF); and Part IV assesses motor complications, including dyskinesias and motor fluctuations.

Time frame: Baseline

International Physical Activity Questionnaire (IPAQ)

The International Physical Activity Questionnaire (IPAQ) is a 7-item self-report instrument assessing physical activity during the previous 7 days. Physical activity is expressed as MET-minutes/week, with higher scores indicating greater physical activity. Participants are classified as having low (\<600 MET-min/week), moderate (600-2999 MET-min/week), or high (≥3000 MET-min/week) physical activity levels.

Time frame: Baseline

Mini-Mental State Examination (MMSE) (Folstein et al., 1975; Spanish validation: Lobo et al., 1999)

The Mini-Mental State Examination (MMSE) is a widely used cognitive screening tool designed to assess global cognitive function and detect cognitive impairment or dementia. It is commonly used in both clinical practice and research to monitor cognitive status over time. The MMSE evaluates five cognitive domains: orientation to time and place, immediate memory registration, attention and calculation, language, and visuospatial construction. Total scores range from 0 to 30, with higher scores indicating better cognitive performance. Cognitive impairment is typically classified as normal (24-30), mild (19-23), moderate (10-18), or severe (0-9). Interpretation of results should consider the participant's educational level, as years of formal education may influence performance

Time frame: Baseline

Handgrip Strength Assessment

Upper-limb muscle strength will be assessed using a Saehan SH5001 hydraulic hand dynamometer (Saehan Corporation). Participants will perform the test in either a standing or seated position, with the elbow extended and slightly away from the trunk. Three measurements will be obtained for each hand, and the mean value will be calculated and recorded in kilograms (kg).

Time frame: Baseline

Nine-Hole Peg Test (9HPT) (Proud et al., 2019)

The Nine-Hole Peg Test (9HPT) is a standardized and widely used measure of finger dexterity and upper extremity function. It assesses fine motor coordination by requiring participants to place nine pegs into nine holes on a pegboard and then remove them as quickly as possible, using one hand at a time. During the assessment, participants are seated at a table with the testing apparatus positioned in front of them. The task is performed separately with each hand, typically beginning with the non-dominant hand. The examiner records the time required to complete the task in seconds. Performance is based on completion time, with shorter times indicating greater manual dexterity and better fine motor function.

Time frame: Baseline

Berg Balance Scale (BBS) (Qutubuddin et al., 2005)

The Berg Balance Scale (BBS) is a validated clinical measure of balance performance, functional mobility, and fall risk in individuals with Parkinson's disease. The scale consists of 14 functional tasks that assess balance during sitting, standing, reaching, turning, transfers, and changes in position. Each item is scored on a 5-point scale ranging from 0 (unable to perform) to 4 (performs independently), with a total score ranging from 0 to 56. Higher scores indicate better balance and greater functional independence. Total scores are commonly interpreted as follows: 0-20, high risk of falls and severe dependency; 21-40, moderate risk of falls and moderate dependency; and 41-56, low risk of falls and greater independence. The BBS is widely used in clinical and research settings to evaluate balance impairments and monitor functional outcomes over time.

Time frame: Baseline

Timed Up and Go Test (TUG) (Nocera et al., 2013)

The Timed Up and Go (TUG) test is a validated measure of functional mobility and fall risk in individuals with Parkinson's disease. Participants are instructed to stand up from a chair with armrests, walk 3 meters, turn around, walk back to the chair, and sit down. Performance is assessed by recording the time (seconds) required to complete the task. Shorter completion times indicate better functional mobility, while longer times are associated with a greater risk of falls.

Time frame: Baseline