Abstract

Background:

People with Parkinson’s disease (PD) frequently experience reading difficulties. Little is known about what functional impairments distinguish people with PD with and without reading difficulties and how these should guide rehabilitation.

Objective:

To provide concrete advice for an efficient stepped care model for reading difficulties in PD, based on extensive functional assessments.

Methods:

This study included 74 people with PD in a neurovisual rehabilitation setting who underwent assessment of visual, visuoperceptual, and cognitive functions. Outcomes were compared between those with frequent (RD+; N = 55) and infrequent reading difficulties (RD–; N = 19). Aids and advice provided during rehabilitation were registered.

Results:

Only a few functions appeared to distinguish RD+ and RD–. Visual functions (i.e., contrast sensitivity, g = 0.76; reading acuity, g = 0.66; visual acuity, g = 0.54) and visuoperceptual functions (i.e., visual attention, g = 0.58, visual motor speed, g = 0.56) showed significant worse scores in RD+ compared to RD–. Aids and advice applied consisted mainly of optimizing refraction, improving lighting, and optimizing text size and spacing.

Conclusion:

The test battery showed significant differences between RD+ and RD–on only a few tests on visual and visuoperceptual functions. The applied aids and advice matched well with these impairments. Therefore, we recommend a stepped care model, starting with a short test battery on these functions. If this battery indicates functional impairments, this can be followed by standard aids and advice to improve reading. Only in case of insufficient effect additional testing should take place.

中文翻译：

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帕金森病的阅读困难：神经视觉康复的阶梯式护理模式

摘要

背景：

患有帕金森病 (PD) 的人经常会遇到阅读困难。对于哪些功能障碍可以区分有或没有阅读困难的帕金森病患者以及这些功能障碍如何指导康复，人们知之甚少。

客观的：

基于广泛的功能评估，为针对 PD 阅读困难的有效阶梯式护理模式提供具体建议。

方法：

这项研究纳入了 74 名接受神经视觉康复治疗的帕金森病患者，他们接受了视觉、视觉知觉和认知功能的评估。对经常出现阅读困难（RD+；N = 55）和不经常出现阅读困难（RD-；N = 19）的患者的结果进行了比较。康复期间提供的援助和建议均已登记。

结果：

只有少数函数出现可以区分 RD+ 和 RD–。视觉功能（即对比敏感度，g = 0.76；阅读敏锐度，g = 0.66；视敏度，g = 0.54）和视觉知觉功能（即视觉注意力，g = 0.58，视觉运动速度，g = 0.56）表现出明显较差RD+ 得分与 RD– 得分相比。所采用的帮助和建议主要包括优化折射、改善照明以及优化文本大小和间距。

结论：

仅在少数视觉和视觉知觉功能测试中，测试电池就显示出 RD+ 和 RD- 之间存在显着差异。所应用的辅助工具和建议与这些缺陷非常匹配。因此，我们建议采用阶梯式维护模式，从对这些功能进行短期测试电池开始。如果该电池显示有功能障碍，则可以提供标准帮助和建议来提高阅读能力。只有在效果不足的情况下才应进行额外的测试。