Skilled Hand Dexterity in Parkinson's Disease: Effects of Adding a Concurrent Task

Background. Hand functionality and finger dexterity are impaired in patients with Parkinson’s disease (PD). These disturbances lead to a dependency in activities of daily living (ADL) and poor quality of life (QoL). Objective. We aimed to evaluate whether a specific occupational therapy (OT) program is effective in improving finger and hand dexterity and its impact on ADL in PD patients. Methods. We retrospectively studied PD patients, hospitalized for a 4-week multidisciplinary intensive rehabilitation treatment (MIRT) between January 2015 and June 2018. All patients underwent 1 h/day OT treatment, 5 days a week. The primary outcome measure was the O’Connor finger dexterity test; secondary outcome measures were the Minnesota dexterity test, UPDRS II, and Self-Assessment Parkinson’s Disease Disability Scale (SPDDS). These measures were assessed at admission (T0) and discharge (T1). Results. Based on the Hoehn and Yahr scale (H&Y), patients were divided into two groups: 262 subjects in H&Y stage <3 (early-stage PD patients) and 220 in H&Y stage ≥3 (medium-advanced stage PD patients). As expected, at baseline, all measures were worse in higher H&Y stages. After treatment, both groups experienced significant improvements in all outcomes. Significant differences between early-stage and medium-advanced stage PD patients were observed only for the changes in UPDRS II, with a better improvement in patients in H&Y stage ≥3. Conclusions. We showed that PD patients who underwent a rehabilitation protocol including OT experienced improvements in finger dexterity and hand functionality. Our results underline the relevance of OT in improving autonomy and QoL in PD patients.

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Improvement of hand dexterity induced by stimulation of the peduncolopontine nucleus in a patient with advanced Parkinson’s disease and previous long-lasting bilateral subthalamic DBS

Acta Neurochirurgica ◽

10.1007/s00701-011-1051-0 ◽

2011 ◽

Vol 153 (8) ◽

pp. 1587-1590 ◽

Cited By ~ 4

Author(s):

Angelo Franzini ◽

Giuseppe Messina ◽

Edvin Zekaj ◽

Luigi Romito ◽

Roberto Cordella

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Advanced Parkinson’S Disease ◽

Hand Dexterity ◽

Stimulation Of

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Wuqinxi Exercise Improves Hand Dexterity in Patients with Parkinson’s Disease

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2020/8352176 ◽

2020 ◽

Vol 2020 ◽

pp. 1-9

Author(s):

Tian Wang ◽

Guiping Xiao ◽

Zhenlan Li ◽

Kuncheng Jie ◽

Mengyue Shen ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Motor Function ◽

Standing Position ◽

Dominant Hand ◽

Emotional Wellbeing ◽

Single Session ◽

Training Interventions ◽

Hand Dexterity ◽

Before And After

Objective. This study was designed to evaluate the effect of Wuqinxi after one session and 12-week intervention on hand dexterity in patients with Parkinson’s disease (PD). Methods. Forty-six elderly participants with mild-to-moderate PD were randomly assigned to the groups trained with Wuqinxi (n = 23) or stretching (n = 23). All participants practiced 60 min session of either of these exercises, 2 sessions a week for 12 weeks in standing position. The score of Purdue Pegboard Test (PPT) and time for Soda Pop Test (SPT) were performed to assess hand dexterity and motor function along assessing the 39 items of Parkinson’s Disease Questionnaire before and after 12-week interventions. In addition, the PPT scores were compared before vs. after one session of either of these two exercise modes. Results. Single session with either Wuqinxi or stretching exercise tended to improve PPT scores in PD patients. Furthermore, the improved SPT time was significant ( P < 0.01 ) following 12-week training interventions with Wuqinxi (−1.32 ± 0.38 sec) or stretching (−0.89 ± 0.16 sec), which showed no group difference ( P = 0.734 ). However, only the participants in Wuqinxi group significantly improved the PPT scores of the dominant hand (+0.61 ± 1.34), both hand (+1.83 ± 3.13) and assemble (+2.04 ± 3.44) performance after 12-week training intervention. In parallel with improved hand dexterity and motor function, 12-week Wuqinxi training also significantly improved the patient’s emotional wellbeing. Conclusion. The Wuqinxi intervention could be safely and effectively applied to improve hand dexterity following single-session exercise or 12-week training, which were accompanied by improved quality of life in patients with mild-to-moderate PD.

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Attention and grasping in Parkinson's disease: Effects of treatment and disease stages

Clinical & Investigative Medicine ◽

10.25011/cim.v30i4.2864 ◽

2007 ◽

Vol 30 (4) ◽

pp. 87

Author(s):

Cathy Lu ◽

Oksana Suchowersky ◽

Zelma Kiss ◽

Angela M Haffenden

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Activities Of Daily Living ◽

Dual Task ◽

Daily Living ◽

De Novo ◽

Concurrent Task ◽

Imagery Task ◽

Reach To Grasp ◽

Attentional Resources

Objective: To compare the attentional resources devoted to reach-to-grasp movements at different stages of Parkinson’s disease (PD), on and off treatment, relative to intact controls. Background: Reach-to-grasp movements are a critical component of activities of daily living. The grasping movements of patients with PD are characterized by a reliance on cues and visual feedback, not seen in the very automatic movements of intact controls (Azulay et al, 2006). PD patients appear to devote significant attentional resources to their movements; dual-task performance is a well-known area of difficulty for PD patients. To date, the role of attention in everyday reach-to-grasp movements has not been examined, though the implications for performance of activities of daily living are clearly considerable. Methods: The performance of three patient groups [de novo (n=11); moderate (n=24); and surgical (STN DBS; n=14)] was compared with age matched controls (n=24) on a dual task paradigm involving grasping and a concurrent cognitive task designed to consume attention. Attentional resources were measured with standardized tests. Participants reached to grasp functional objects with handles (e.g. a comb). Handles were turned away from participants; an appropriate grasp was scored if they successfully picked up the object by the handle. Between and within group comparisons were made using ANOVA and t-tests. Results: The control group and the de novo group not yet on medication displayed strong evidence of automaticity in their movements; when performing a challenging spatial imagery task, they made the same number of appropriate grasps as when they picked up the objects without a concurrent task. In contrast, for the moderate and the surgical groups, performing the concurrent task resulted in fewer appropriate grasps, and there was no improvement while on treatment (medication and stimulation, respectively). Only the surgical group showed decreased divided attention on standardized measures (>-0.7 SD below their normative group). Conclusions: Grasping appears to shift from an automatic to an attention demanding process by the moderate stages of PD. This may be a coping mechanism designed to safely adapt to reduced motor function, or it may reflect pathology in the mechanisms underlying grasping movements. References: Azulay JP, Mesure S, and Blin O. 2006. J Neurol Sci, 248(1-2): 192-195.

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