Daily physical function and frailty in persons with Parkinson's disease : a focus on females
Bibliographic record
Abstract
Persons with Parkinson’s disease (PD) are often excluded from frailty studies, and thus little is known about how frailty influences decline in physiological capacity in persons with PD. Impaired physiological capacity impacts the ability to remain physically active, which reduces physical function necessary for independent living. The overall purpose of this dissertation was to examine physiological capacity (i.e., muscle activation patterns) and physical activity in males and females with PD during routine daily activities to determine whether they influence physical function and frailty. An extensive literature review of sex differences in PD highlights that greater declines in gait speed, balance and motor function occur in females compared with males. This dissertation demonstrated persons with PD and females were weaker and have less muscle quiescence, as measured with gaps in the electromyography (EMG), compared with controls and males with PD. These results provide insight into mechanisms (i.e., physiological capacity) that determine PD and sex-related declines in functional performance. In addition, greater muscle activity and less quiescence in females with PD may perpetuate frailty through increased muscle fatigue and slowness of movement. Females with PD are more vulnerable to prefrailty than males and factors that are associated with frailty are quality of life (QoL) and self-reported exhaustion. The neuromuscular changes associated with frailty exacerbate PD, which may create greater muscle fatigue resulting in self-reported exhaustion. In conclusion, research presented within this dissertation demonstrates that addressing frailty in PD is important, especially in females who are at greater risk for functional decline. This research presents new knowledge by suggesting frail females with PD remain physically active during daily life and that disease management may better reflect frailty than disease severity or duration. Understanding how frailty concurrently exists with PD and how these conditions progress within the aging adult may enhance identification and implementation of management strategies aimed at improving functional independence and QoL.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".