Objective: To develop  a bedside  quantitative test for evaluating motor affectation  in patients with Parkinson’s Disease.

Background: The MDS-UPDRS part III is still the most common scale for assessing patients with PD despite the efforts to implement  instrumental or wearable devices . Objective quantification of parkinsonism for non trained health care providers is still challenging.

Method: We evaluated a consecutive series of  PD patients who underwent  a levodopa challenge. An ad hoc timed test “ coat test”  comprising three stages: standing up from a chair with arms crossed and walking to a coat rack located 5 meters from the chair (T1), taking a coat from the rack and putting it on (T2), buttoning the coat, removing a wallet from the pocket, and taking out a credit card (T3) was performed. Patients were given instructions to perform the tasks as quickly as possible without running, and the time taken for each stage was recorded separately. This procedure was performed at baseline and 40, 80 and 120 minutes post-administration of 250/25 mg of levodopa/carbidopa. A linear correlation between time and MDS-UPDRS score was calculated for each assessment.

Results: 51 consecutive PD patients were included between 48 and 91 years old. A significant linear correlation between the total time needed to complete the “coat test” and MDS-UPDRS part III in the OFF-state (R=0.403, p=0.007) as well as during the ON-state (R=0.525, p<0.005) were found . This correlation was also observed  each partial time and the total UPDRS III : T1 (R=0.351, p=0.021); T2 (R=0.426, p=0.004) and T3 (R=0.338, p=0.027) during the OFF-state, and T1 (R=0.603, p<0.0005); T2 (R=0.624, p<0.0005) and T3 (R=0.963, p<0.0005).

Conclusion: A simple bedside timed test with good correlation with UPDRS III scores is feasible. It takes less than 2 minutes, can be performed by not trained health professionals and can be used to follow up PD patients at the clinic.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/coat-test-a-bedside-timed-test-for-quantifying-motor-function-in-parkinsons-disease-patients/