PERBANDINGAN KUALITAS HIDUP PASIEN PARKINSON SUBTIPE TREMOR DOMINANT DAN POSTURAL INSTABILITY GAIT DISORDER

MARISSA AYU ANINDYTA, Prof. Dr. dr. Sri Sutarni, Sp.S (K); dr. Subagya, Sp.S (K)

2017 | Tesis-Spesialis | SP ILMU PENYAKIT SYARAF

Latar Belakang: Penyakit Parkinson merupakan penyakit neurodegeneratif yang progresif dengan gejala motorik dan non motorik yang bervariasi. Prevalensi dan insidensi penyakit Parkinson semakin meningkat seiring bertambahnya umur. Subtipe penyakit Parkinson yakni subtipe yang memiliki klinis tremor lebih dominan (tremor dominant) dan klinis instabilitas postural atau gait yang dominan (postural instability gait disorder). Kedua subtipe Parkinson tersebut memiliki perbedaan dalam hal klinis, imaging, genetik, dan tanda patologis. Penelitian ini bertujuan untuk mengetahui perbandingan kualitas hidup pasien Parkinson subtipe tremor dominant dan postural instability gait disorder. Metode: Penelitian ini merupakan penelitian cross-sectional. Pada penelitian ini, dinilai perbandingan kualitas hidup antara 22 pasien Parkinson subtipe tremor dominant dan 22 subtipe postural instability gait disorder di poliklinik saraf RSUP Dr. Sardjito Yogyakarta, RSUP Dr. Soeradji Tirtonegoro Klaten, RSUD Tjitrowardojo Purworejo. Pemeriksaan kualitas hidup dinilai dengan kuesioner PDQ- 39. Data sampel penelitian dilakukan analisis data dengan perhitungan statistik. Hasil: Hasil analisis komparatif menunjukan adanya perbedaan rerata skor PDQ-39 pada kedua subtipe parkinson dimana kualitas hidup subtipe tremor dominant lebih baik dibandingkan postural instability gait disorder (p=0,017). Perbedaan yang bermakna terutama pada aspek mobilitas (p=0,009) dan activity daily living (p=0,005) dimana rerata skor PDQ-39 aspek tersebut lebih tinggi pada subtipe PIGD dibandingkan TD. Berdasarkan hasil analisis multivariat, faktor yang berpengaruh secara signifikan terhadap kualitas hidup adalah subtipe Parkinson (p=0,013). Kesimpulan: Pada penelitian ini didapatkan kualitas hidup subtipe tremor dominant secara signifikan lebih baik dibandingkan dengan subtipe postural instability gait disorder.

Background: Parkinson's disease is a progressive neurodegenerative disease with varied motoric and non-motoric symptoms. The prevalence and incidence of Parkinson's disease increase with age. The common subtypes of Parkinson's disease are subtypes with more dominant clinical tremor (tremor dominant) and clinical postural instability or gait disorder (postural instability gait disorder). Both of these Parkinson's subtypes differ in clinical, imaging, genetic, and pathological features. This study aims to determine the quality of life of patients with tremor dominant and postural instability gait disorder subtype of Parkinson's. Method: This was a cross-sectional study. In this study, we assessed the quality of life comparison between 22 tremor dominant subtype of Parkinson's and 22 postural instability gait disorder subtypes in Dr. Sardjito hospital Yogyakarta, Dr. Soeradji Tirtonegoro hospital Klaten, Tjitrowardojo hospital Purworejo. Quality of life were assessed with the PDQ-39 questionnaire. Data sample research is done by data analysis with statistical calculation. Results: The results of the comparative analysis showed a difference in mean score PDQ-39 in both subtypes of Parkinson's where the quality of life of tremor dominant subtype was better than postural instability gait disorder (p=0.017). The significant differences were mainly in the mobility aspect (p=0.009) and the daily living activity (p=0.005) where the mean PDQ-39 score was higher in the PIGD subtype than the TD. Based on the results of multivariate analysis, the factors that significantly influence the quality of life were Parkinson's subtypes (p=0.013). Conclusion: The quality of life of tremor dominant subtype is significantly better than postural instability gait disorder subtype.

Kata Kunci : parkinson, tremor dominant, postural instability gait disorder, quality of life