California Physical Therapy Ebook Continuing Eduction - PTC…

Š Benítez-Rivero, S., Lama, M. J., Huertas-Fernández, I., Alvarez de Toledo, P., Cáceres-Redondo, M. T., Martín-Rodríguez, J. F., Carrillo, F., Carballo, M., Paolmar, F. J., & Mir, P. (2014). Clinical features and neuropsychological profile in vascular parkinsonism. Journal of the Neurological Sciences, 345 (1-2), 193-197. Š Bertolini, G., Wicki, A., Baumann, C. R., Straumann, D., & Palla, A. (2015). Impaired tilt perception in Parkinson’s disease: A central vestibular integration failure. PLoS One, 10 (4), e0124253. Š Bloem, B. R., Hausdorff, J. M., Visser, J. E., & Giladi, N. (2004). Falls and freezing of gait in Parkinson’s disease: A review of two interconnected, episodic phenomena. Movement Disorders Journal, 19 (8), 871-884. Š Bzdúšková, D., Valkovič, P., Hirjaková, Z., Kimijanová, J., & Hlavačka, F. (2018). Parkinson's disease versus ageing: Different postural responses to soleus muscle vibration. Gait & Posture, 65 , 169-175. https://doi. org/10.1016/j.gaitpost.2018.07.162 Š Cano-de-la-Cuerda, R., Pérez-de-Heredia, M., Miangolarra-Page, J. C., Muñoz-Hellín, E., & Fernandez-de-las- Peñas, C. (2010). Is there muscular weakness in Parkinson’s disease? American Journal of Physical Medicine & Rehabilitation, 89 (1), 70-76. Š Carter, V., Jain, T., James, J., Cornwall, M., Aldrich, A., & de Heer, H. D. (2019). The 3-m backwards walk and retrospective falls: Diagnostic accuracy of a novel clinical measure. Journal of Geriatric Physical Therapy, 42 (4), 249-255. https://doi.org/10.1519/JPT.0000000000000149 Š Cavanaugh, J. T., Ellis, T. D., Earhart, G. M., Ford, M. P., Foreman, K. B., & Dibble, L. E. (2015). Toward understanding ambulatory activity decline in Parkinson disease. Physical therapy, 95 (8), 1142-1150. https://doi. org/10.2522/ptj.20140498 Š Cesari, M., Kritchevsky, S. B., Penninx, B. W., Nicklas, B. J., Simonsick, E. M., Newman, Š A. B., Tylavsky, F. A., Brach, J. S., Satterfield, S., Bauer, D. C., Visser, M., Rubin, S. M., Harris, T. B., & Pathor, M. (2005). Prognostic value of usual gait speed in well-functioning older people: Results from the Health, Aging and Body Composition Study. Journal of the American Geriatrics Society , 53 (10), 1675-1680. Š Corcos, D. M., Robichaud, J. A., David, F. J., Leurgans, S. E., Vaillancourt, D. E., Poon, C., Rafferty, M. R., Kohrt, W. M., & Comella, C. L. (2013). A two-year randomized controlled trial of progressive resistance exercise for Parkinson’s disease. Movement Disorders Journal, 28 (9), 1230-1240. Š Cosentino, C., Baccini, M., Putzolu, M., Ristori, D., Avanzino, L., & Pelosin, E. (2020). Effectiveness of physiotherapy on freezing of gait in Parkinson's disease: A systematic review and meta-analyses. Movement Disorders: Official Journal of the Movement Disorder Society , 35 (4), 523-536. https://doi.org/10.1002/ mds.27936 Š Cramer, S. C., Sur, M., Dobkin, B. H., O’Brien, C., Sanger, T. D., Trojanowski, J. Q., Rumsey, J. M., Hicks, R., Cameron, J., Chen, D., Chen, W. G., Cohen, L. G., deCharms, C., Duffy, C. J., Eden, G. F., Fetz, E. F., Filart, R., Freund, M., Grant, S. J., … Vinogradov, S. (2011). Harnessing neuroplasticity for clinical applications. Brain, 134 (Pt. 6), 1591-1609. Š Cugusi, L., Solla, P., Zedda, F., Loi, M., Serpe, R., Cannas, A., Marrosu, F., & Mercuro, G. (2014). Effects of an adapted physical activity program on motor and non-motor functions and quality of life in patients with Parkinson’s disease. NeuroRehabilitation, 35 (4), 789-794. Š Dibble, L. E., Hale, T. F., Marcus, R. L., Gerber, J. P., & LaStayo, P. C. (2009). High intensity eccentric resistance training decreases bradykinesia and improves quality of life in persons with Parkinson’s disease: A preliminary study. Parkinsonism & Related Disorders, 15 (10), 752-757. Š Dorsey, E. R., Sherer, T., Okun, M. S., & Bloem, B. R. (2018). The emerging evidence of the Parkinson pandemic. Journal of Parkinson's Disease, 8 (s1), S3-S8. https://doi.org/10.3233/JPD-181474 Š dos Santos Mendes, F. A., Pompeu, J. E., Modenesi Lobo, A., Guedes da Silva, K., Oliveira Tde, P., Peterson Zomignani, A., & Pimentel Piemonte, M. E. (2012). Motor learning, retention and transfer after virtual-reality- based training in Parkinson’s disease–effect of motor and cognitive demands of games: A longitudinal, controlled clinical study. Physiotherapy, 98 (3), 217-223. Š Duncan, R. P., Leddy, A. L., Cavanaugh, J. T., Dibble, L. E., Ellis, T. D., Ford, M. P., Foreman, K. B., & Earhart, G. M. (2013). Comparative utility of the BESTest, Mini-BESTest, and Brief-BESTest for predicting falls in individuals with Parkinson disease: A cohort study. Physical Therapy, 93 (4), 542-550. Š Duncan, R. P., Leddy, A. L., & Earhart, G. M. (2011). Five times sit-to-stand test performance in Parkinson's disease. Archives of Physical Medicine and Rehabilitation, 92 (9),1431‐1436. 10.1016/j.apmr.2011.04.008 Š Ebersbach, G., Grust, U., Ebersbach, A., Wegner, B., Gandor, F., & Kühn, A. A. (2015). Amplitude-oriented exercise in Parkinson’s disease: A randomized study comparing LSVT-BIG and a short training protocol. Journal of Neural Transmission, 122 (2), 253-256. 10.1007/s00702-014-1245-8 Š Elbers, R. G., van Wegen, E. E., Verhoef, J., & Kwakkel, G. (2013). Is gait speed a valid measure to predict community ambulation in patients with Parkinson’s disease? Journal of Rehabilitation Medicine, 45 (4), 370- 375. Š Ellis, T., Boudreau, J. K., Deangelis, T. R., Brown, L. E., Cavanaugh, J. T., Earhart, G. M., Ford, M. P., Foreman, K. B., & Dibble, L. E. (2013). Barriers to exercise in people with Parkinson disease. Physical Therapy, 93 (5), 628-636. Š Esculier, J. F., Vaudrin, J., Beriault, P., Gagnon, K., & Tremblay, L. E. (2012). Home-based balance training programme using Wii Fit with balance board for Parkinson’s disease: A pilot study. Journal of Rehabilitation Medicine, 44 (2), 144-150. Š Evans, K., Refshauge, K. M., & Adams, R. (2006). Measurement of active rotation in standing: Reliability of a simple test protocol. Perceptual and Motor Skills, 103 (2), 619-628. Š Faber, M. J., Bosscher, R. J., & van Wieringen, P. C. W. (2006). Clinimetric properties of the performance- oriented mobility assessment. Physical Therapy, 86 (7), 944-954. Š Fabbrini, G., Fabbrini, A., & Suppa, A. (2019). Progressive supranuclear palsy, multiple system atrophy and corticobasal degeneration. Handbook of Clinical Neurology, 165 , 155-177. https://doi.org/10.1016/B978-0- 444-64012-3.00009-5 Š Falvo, M. J., & Earhart, G. M. (2009). Six-minute walk distance in persons with Parkinson disease: A hierarchical regression model. Archives of Physical Medicine and Rehabilitation, 90 (6), 1004-1008. Š Farley, B. G., & Koshland, G. F. (2005). Training BIG to move faster: The application of the speed-amplitude relation as a rehabilitation strategy for people with Parkinson’s disease. Experimental Brain Research, 167 (3), 462-467. Š Fisher, B. E., Li, Q., Nacca, A., Salem, G. J., Song, J., Yip, J., Hui, J. S., Jakowec, M. W., & Petzinger, G. M. (2013). Treadmill exercise elevates striatal dopamine D2 receptor binding potential in patients with early Parkinson’s disease. Neuroreport, 24 (10), 509-514. Š Fisher, B. E., Wu, A. D., Salem, G. J., Song, J., Lin, C. H., Yip, J., Cen, S., Gordan, J., Jakowec, M., & Petzinger, G. (2008). The effect of exercise training in improving motor performance and corticomotor excitability in people with early Parkinson’s disease. Archives of Physical Medicine and Rehabilitation, 89 (7), 1221-1229. Š Fox, C., Ebersbach, G., Ramig, L., & Sapir, S. (2012). LSVT LOUD and LSVT BIG: Behavioral treatment programs for speech and body movement in Parkinson disease. Parkinson’s Disease , 391946. Š Fritz, N. E., Kegelmeyer, D. A., Kloos, A. D., Linder, S., Park, A., Kataki, M., Adeli, A., Agrawal, P., Scharre, D. W., & Kostyk, S. K. (2016). Motor performance differentiates individuals with Lewy body dementia, Parkinson’s and Alzheimer’s disease. Gait & Posture, 50 , 1-7. Š Fritz, N. E., Worstell, A. M., Kloos, A. D., Siles, A. B., White, S. E., & Kegelmeyer, D. A. (2012). Backward walking measures are sensitive to age-related changes in mobility and balance. Gait & Posture, 37 (4), 593-597. Š Ghai, S., Ghai, I., Schmitz, G., & Effenberg, A. O. (2018). Effect of rhythmic auditory cueing on parkinsonian gait: A systematic review and meta-analysis. Scientific Reports, 8 (1), 506. https://doi.org/10.1038/s41598-017- 16232-5 Š Giladi, N., Tal, J., Azulay, T., Rascol, O., Brooks, D. J., Melamed, E., Oertel, W., Poewe, W. H., Stocchi, F., & Tolosa, E. (2009). Validation of the freezing of gait questionnaire in patients with Parkinson’s disease. Movement Disorders Journal, 24 (5), 655-661. Š Goetz, C. G., Poewe, W., Rascol, O., Sampaio, C., Stebbins, G. T., Counsell, C., Giladi, N., Holloway, R. G., Moore, C. G., Wenning, G. K., Yahr, M. D., Seidl, L., & Movement Disorder Society Task Force on Rating Scales for Parkinson's Disease. (2004). Movement Disorder Society Task Force on the Hoehn and Yahr staging scale: Status and recommendations. Movement Disorder Society Task Force report on rating scales for Parkinson’s disease. (2004). Movement Disorders Journal, 19 (9), 1020-1028. Š Gorton, L. M., Vuckovic, M. G., Vertelkina, N., Petzinger, G. M., Jakowec, M. W., & Wood, R. I. (2010). Exercise effects on motor and affective behavior and catecholamine neuro- chemistry in the MPTP-lesioned mouse. Behavioural Brain Research, 213 (2), 253-262. Š Gretebeck, R. J., Ferraro, K. F., Black, D. R., Holland, K., & Gretebeck, K. A. (2012). Longitudinal change in physical activity and disability in adults. American Journal of Health Behavior, 36 (3), 385-394. Š Hackney, M. E., & Earhart, G. M. (2009). Backward walking in Parkinson’s disease. Movement Disorders Journal, 24 (2), 218-223. Š Hackney, M. E., Kantorovich, S., Levin, R., & Earhart, G. M. (2007). Effects of tango on functional mobility in Parkinson’s disease: A preliminary study. Journal of Neurologic Physical Therapy, 3 1(4), 173-179. Š Hagell, P., Tornqvist, A. L., & Hobart, J. (2008). Testing the SF-36 in Parkinson’s disease: Implications for reporting rating scale data. Journal of Neurology, 255 (2), 246-254. Š Herman, T., Dagan, M., Shema-Shiratzky, S., Reches, T., Brozgol, M., Giladi, N., Manor, B., & Hausdorff, J. M. (2020). Advantages of timing the duration of a freezing of gait-provoking test in individuals with Parkinson's disease. Journal of Neurology . https://doi.org/10.1007/s00415-020-09856-7 Š Herman, T., Giladi, N., & Hausdorff, J. M. (2009). Treadmill training for the treatment of gait disturbances in people with Parkinson’s disease: A mini-review. Journal of Neural Transmission, 116 (3), 307-318. Š Hoehn, M., & Yahr, M. D. (1967). Parkinsonism: Onset, progression, and mortality. Neurology, 17 (5), 427-442. Š Hoskovcová, M., Dušek, P., Sieger, T., Brožová, H., Zárubová, K., Bezdíček, O., Šprdlík, O., Jech, R., Štochl, J., Roth, J., & Růžička, E. (2015). Predicting falls in Parkinson disease: What is the value of instrumented testing in OFF medication state? PLoS One, 10 (10), e0139849.

Š Hubble, R. P., Silburn, P. A., Naughton, G. A., & Cole, M. H. (2019). Trunk exercises improve balance in Parkinson disease: A phase II randomized controlled trial. Journal of Neurologic Physical Therapy, 43 (2), 96- 105. https://doi.org/10.1097/NPT.0000000000000258 Š Hwang, S., Agada, P., Grill, S., Kiemel, T., & Jeka, J. J. (2016). A central processing sensory deficit with Parkinson's disease. Experimental Brain Research, 234 (8), 2369-2379. https://doi.org/10.1007/s00221-016- 4642-4 Š Jacobs, J. V., & Horak, F. B. (2006). Abnormal proprioceptive-motor integration contributes to hypometric postural responses of subjects with Parkinson’s disease. Neuroscience, 141 (2), 999-1009. Š Juárez Olguín, H., Calderón Guzmán, D., Hernández García, E., & Barragán Mejía, G. (2016). The role of dopamine and its dysfunction as a consequence of oxidative stress. Oxidative Medicine and Cellular Longevity, 2016 , 9730467. https://doi.org/10.1155/2016/9730467 Š Kataoka, H., Tanaka, N., Eng, M., Saeki, K., Kiriyama, T., Eura, N., Ikeda, M., Izumi, T., Kitauti, T., Furiya, Y., Sugie, K., Ikada, Y., & Ueno, S. (2011). Risk of falling in Parkinson’s disease at the Hoehn-Yahr stage III. European Neurology, 66 (5), 298-304. Š Kegelmeyer, D. A., Kloos, A. D., Thomas, K. M., & Kostyk, S. K. (2007). Reliability and validity of the Tinetti Mobility Test for individuals with Parkinson disease. Physical Therapy, 87 (10), 1369-1378. Š Kegelmeyer, D. A., Parthasarathy, S., Kostyk, S. K., White, S. E., & Kloos, A. D. (2013). Assistive devices alter gait patterns in Parkinson disease: Advantages of the four- wheeled walker. Gait & Posture, 38 (1), 20-24. Š Keus, S. H., Munneke, M., Nijkrake, M. J., Kwakkel, G., & Bloem, B. R. (2009). Physical therapy in Parkinson’s disease: Evolution and future challenges. Movement Disorders Journal, 24 (1), 1-14. Š Kloos, A. D., Kegelmeyer, D. A., Ambrogi, K., Kline, D., McCormack-Mager, M., Schroeder, B., & Kostyk, S. K. (2019). The Step Test Evaluation of Performance on Stairs (STEPS): Validation and reliability in a neurological disorder. PLOS ONE, 14 (3), e0213698. https://doi.org/10.1371/journal.pone.0213698 Š Kloos, A. D., Kegelmeyer, D. A., White, S. E., & Kostyk, S. K. (2012). The impact of different types of assistive devices on gait measures and safety in Huntington’s disease. PLOS One, 7 (2), e30903. Š Kuroda, K., Tatara, K., Takatorige, T., & Shinsho, F. (1992). Effect of physical exercise on mortality in patients with Parkinson’s disease. Acta Neurologica Scandinavica, 86 (1), 55-59. Š Langhammer, B., & Lindmark, B. (2012). Functional exercise and physical fitness post stroke: The importance of exercise maintenance for motor control and physical fitness after stroke. Stroke Research and Treatment , 864835. Š Leddy, A. L., Crowner, B. E., & Earhart, G. M. (2011). Functional gait assessment and balance evaluation system test: Reliability, validity, sensitivity, and specificity for identifying individuals with Parkinson disease who fall. Physical Therapy, 91 (1), 102-113. Š Li, F., Harmer, P., Fitzgerald, K., Eckstrom, E., Stock, R., Galver, J., Maddalozzo, G., & Batya, S. S. (2012). Tai chi and postural stability in patients with Parkinson’s disease. New England Journal of Medicine, 366 (6), 511-519. Š Maitra, K. K. (2007). Enhancement of reaching performance via self-speech in people with Parkinson’s disease. Clinical Rehabilitation, 21 (5), 418-424. Š Majsak, M. J., Kaminski, T., Gentile, A. M., & Gordon, A. M. (2008). Effects of a moving target versus a temporal constraint on reach and grasp in patients with Parkinson’s disease. Experimental Neurology, 210 (2), 479-488. Š Mehrholz, J. R., Kugler, J., Storch, A., Pohl, M., Elsner, B., & Hirsch, K. (2015). Treadmill training for patients with Parkinson’s disease. 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K., Jacobs, J. V., & Kasser, S. L. (2012). Is the BESTest at its best? A suggested brief version based on interrater reliability, validity, internal consistency, and theoretical construct. Physical Therapy, 92 (9), 1197- 1207. Š Pang, M. Y., & Mak, M. K. (2009). Trunk muscle strength, but not trunk rigidity, is independently associated with bone mineral density of the lumbar spine in patients with Parkinson’s disease. Movement Disorders, 24 (8), 1176-1182. 10.1002/mds.22531 Š Pardoel, S., Kofman, J., Nantel, J., & Lemaire, E. D. (2019). Wearable-sensor-based detection and prediction of freezing of gait in Parkinson's disease: A review. Sensors, 19 (23), 5141. https://doi.org/10.3390/s19235141 Š Parkinson’s Disease Foundation. (n.d.). Statistics on Parkinson’ s. http://www.pdf.org/parkinson_statistics Š Poewe, W., Seppi, K., Tanner, C. M., Halliday, G. M., Brundin, P., Volkmann, J., Schrag, A. E., & Lang, A. E. (2017). Parkinson disease. Nature Reviews. Disease Primers, 3 , 17013. https://doi.org/10.1038/nrdp.2017.13 Š Postuma, R. B., Berg, D., Stern, M., Poewe, W., Olanow, C. W., Oertel, W., Obeso, J., Marek, K., Litvan, I., Lang, A. E., Halliday, G., Goetz, C. G., Gasser, T., Dubois, B., Chan, P., Bloem, B. R., Adler, C. H., & Deuschl, G. (2015). MDS clinical diagnostic criteria for Parkinson’s disease. Movement Disorders, 30 (12), 1591-1601. Š Quinn, L., Khalil, H., Dawes, H., Fritz, N. E., Kegelmeyer, D., Kloos, A. D., Gillard, J. W., Busse, M., & Outcome Measures Subgroup of the European Huntington's Disease Network. (2013). Reliability and minimal detectable change of physical performance measures in individuals with pre-manifest and manifest Huntington disease. Physical Therapy, 93 (7), 942-956. Š Ribeiro Artigas, N., Eltz, G. D., do Pinho, A. S., Torman, V. B., Hilbig, A., & Rieder, C. R. (2016). Evaluation of knee proprioception and factors related to Parkinson's disease. Neuroscience Journal, 2016 , 6746010. https:// doi.org/10.1155/2016/6746010 Š Ridgel, A. L., Phillips, R. S., Walter, B. L., Discenzo, F. M., & Loparo, K. A. (2015). Dynamic high-cadence cycling improves motor symptoms in Parkinson’s disease. Frontiers in Neurology, 6, 194. 10.3389/ fneur.2015.00194 Š Rodrigues de Paula, F., Teixeira-Salmela, L. F., Coelho de Morais Faria, C. D., Rocha de Brito, P., & Cardoso, F. (2006). Impact of an exercise program on physical, emotional, and social aspects of quality of life of individuals with Parkinson’s disease. Movement Disorders Journal, 21 (8), 1073-1077. Š Schaafsma, J. D., Giladi, N., Balash, Y., Bartels, A. L., Gurevich, T., & Hausdorff, J. M. (2003). Gait dynamics in Parkinson’s disease: Relationship to parkinsonian features, falls and response to levodopa. Journal of the Neurological Sciences, 212 (1-2), 47-53. Š Scharre, D. W., Chang, S. I., Nagaraja, H. N., Park, A., Adeli, A., Agrawal, P., Kloos, A., Kegelmeyer, D., Linder, S., Fritz, N., Kostyk, S. K., & Kataki, M. (2016). Paired studies comparing clinical profiles of Lewy body dementia with Alzheimer’s and Parkinson’s diseases. Journal of Alzheimer’s Disease, 54 (3), 995-1004. Š Schenkman, M., Hall, D. A., Baron, A. E., Schwartz, R. S., Mettler, P., & Kohrt, W. M. (2012). Exercise for people in early- or mid-stage Parkinson disease: A 16-month randomized controlled trial. Physical Therapy, 92 (11), 1395-1410. Š Schenkman M., McFann, K., & Barón, A. E. (2010). “PROFILE PD”: Profile of function and impairment level experience with PD: Clinimetric properties of a rating scale for physical therapist practice. Journal of Neurologic Physical Therapy, 34 (4), 182-192. Š Snijders, A. H., Haaxma, C. A., Hagen, Y. J., Munneke, M., & Bloem, B. R. (2012). Freezer or non-freezer: Clinical assessment of freezing of gait. Parkinsonism & Related Disorders, 18 (2), 149-154. Š Soke, F., Guclu-Gunduz, A., Kocer, B., Fidan, I., & Keskinoglu, P. (2019). Task-oriented circuit training combined with aerobic training improves motor performance and balance in people with Parkinson's disease. Acta neurologica Belgica . https://doi.org/10.1007/s13760-019-01247-8 Š Tajiri, N., Yasuhara, T., Shingo, T., Kondo, A., Yuan, W., Kadota, T., & Date, I. (2010). Exercise exerts neuroprotective effects on Parkinson’s disease model of rats. Brain Research, 1310, 200-207. Š Tanji, H., Gruber-Baldini, A. L., Anderson, K. E., Pretzer-Aboff, I., Reich, S. G., Fishman, P. S., Weiner, W. J., & Shulman, L. M. (2008). A comparative study of physical performance measures in Parkinson’s disease. Movement Disorders Journal, 23 (13), 1897-1905. Š Tomlinson, C. L., Patel, S., Meek, C., Clarke, C., Stowe, R., Shah, L., Sackley, C. M., Deane, K. H. O., Herd, C. P., Wheatley, K., & Ives, N. (2012). Physiotherapy versus placebo or no intervention in Parkinson’s disease. Cochrane Database of Systematic Reviews, 2012 (9), CD002817. 10.1002/14651858.CD002817.pub Š Tuon, T., Valvassori, S. S., Lopes-Borges, J., Luciano, T., Trom, C. B., Silva, L. A., Quevedo, J., Souza, C. T., Lira, F. S., & Pinho, R. A. (2012). Physical training exerts neuroprotective effects in the regulation of neurochemical factors in an animal model of Parkinson’s disease. Neuroscience, 227 , 305-312. Š Walker, Z., Possin, K. L., Boeve, B. F., & Aarsland, D. (2015). Lewy body dementias. Lancet, 386 (10004), 1683- 1697. Š World Health Organization. (2002). Towards a common language for functioning, disability and health: ICF. World Health Organization, p. 9 . Š Wright, W. G., Gurfinkel, V. S., Nutt, J., Horak, F. B., & Cordo, P. J. (2007). Axial hypertonicity in Parkinson’s disease: Direct measurements of trunk and hip torque. Experimental Neurology, 208 (1), 38-46. Š Yingyongyudha, A., Saengsirisuwan, V., Panichaporn, W., & Boonsinsukh, R. (2016). The Mini-Balance Evaluation Systems Test (Mini-BESTest) demonstrates higher accuracy in identifying older adult participants with history of falls than do the BESTest, Berg Balance Scale, or Timed Up and Go Test. Journal of Geriatric Physical Therapy, 39 (2), 64-70.

EXAMINATION AND MANAGEMENT OF THE CLIENT WITH PARKINSON’S DISEASE, UPDATED Final Examination Questions Select the best answer for each question and mark your answers on the Final Examination Answer Sheet found on page 148, or complete your test online at EliteLearning.com/Book 51. Which of the following factors has been shown to play a role in triggering Parkinson’s disease? a. Carcinogens. b. Genes and environmental factors. c. High-voltage power lines. d. Smoking. 52. A cardinal motor sign of Parkinson’s disease is: a. Bradykinesia. b. Dementia. c. Dysphagia. d. Monotone speech.

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