Reliability, Concurrent Validity, Responsiveness and Measurement Error of the Portuguese Version of Comprehensive Motor Coordination Scale in Individuals With Parkinson's Disease.

Introduction: Assessment of motor coordination in patients with Parkinson's disease (PD) is based on motor performance and does not consider movement quality.

Objective: To validate the Comprehensive Coordination Scale (CCS) in patients with PD and correlate it with motor impairment.

Methods: This cross-sectional and case-control study included 15 individuals with PD and 15 healthy older individuals as controls. Motor impairments were measured using the MDS-UPDRS (Part III). Motor coordination (CCS) was evaluated by five examiners and classified into four domains: upper and lower limbs and unilateral and bilateral tasks. CCS scores were compared between the groups using the Mann-Whitney test; concurrent validity was evaluated using Spearman's correlation between CCS and PD scales; and the inter-rate reliability was calculated by intraclass correlation coefficient (ICC).

Results: There was significant difference between the groups in the upper limb (p < 0.001), lower limb (p = 0.006), unilateral (p < 0.001), bilateral (p = 0.015), and total (p < 0.001) CCS scores. Total CCS score (ICC 0.78), upper limb (ICC 0.71), lower limb (ICC 0.86) and unilateral (ICC 0.74) showed high inter-rate reliability. Bilateral domain (ICC 0.92) showed very high inter-rate reliability. And, there was negative correlation between CCS upper limb and postural tremor of hands (r = -0.716; p = 0.008), unilateral CCS domain with postural tremor of hands (r = -0.687; p = 0.012), and CCS total score with postural tremor of hands (r = -0.804; p = 0.002).

Conclusion: There was high inter-rater agreement for all CCS items, mainly in the lower limb and bilateral tasks. And, there was a moderate-to-very strong correlation between the total and sub-items of the CCS and motor impairment.