Developing and assessing a new web-based tapping test for measuring distal movement in Parkinson’s disease: a Distal Finger Tapping test

AbstractDisability in Parkinson’s disease (PD) is measured by standardised scales including the MDS-UPDRS, which are subject to high inter and intra-rater variability and fail to capture subtle motor impairment. The BRadykinesia Akinesia INcoordination (BRAIN) test is a validated keyboard tapping test, evaluating proximal upper-limb motor impairment. Here, a new Distal Finger Tapping (DFT) test was developed to assess distal upper-limb function. Kinetic parameters of the test include kinesia score (KS20, key taps over 20 s), akinesia time (AT20, mean dwell-time on each key) and incoordination score (IS20, variance of travelling time between key taps). To develop and evaluate a new keyboard-tapping test for objective and remote distal motor function in PD patients. The DFT and BRAIN tests were assessed in 55 PD patients and 65 controls. Test scores were compared between groups and correlated with the MDS-UPDRS-III finger tapping sub-scores. Nine additional PD patients were recruited for monitoring motor fluctuations. All three parameters discriminated effectively between PD patients and controls, with KS20 performing best, yielding 79% sensitivity for 85% specificity; area under the receiver operating characteristic curve (AUC) = 0.90. A combination of DFT and BRAIN tests improved discrimination (AUC = 0.95). Among three parameters, KS20 showed a moderate correlation with the MDS-UPDRS finger-tapping sub-score (Pearson’s r = − 0.40, p = 0.002). Further, the DFT test detected subtle changes in motor fluctuation states which were not reflected clearly by the MDS-UPDRS-III finger tapping sub-scores. The DFT test is an online tool for assessing distal movements in PD, with future scope for longitudinal monitoring of motor complications.

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Developing and Validating a New Web-Based Tapping Test for Measuring Distal Bradykinesia in Parkinson’s Disease

10.1101/2020.06.30.20141572 ◽

2020 ◽

Author(s):

Noreen Akram ◽

Haoxuan Li ◽

Aaron Ben-Joseph ◽

Caroline Budu ◽

David Gallagher ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Upper Limb ◽

Characteristic Curve ◽

Motor Impairment ◽

Motor Fluctuation ◽

Motor Dysfunction ◽

Upper Limb Function ◽

Travelling Time ◽

User Friendly

ABSTRACTBackgroundDisability in Parkinson’s disease (PD) is measured by standardised scales including the MDS-UPDRS, which are subject to high inter and intra-rater variability and fail to capture subtle motor impairment. The BRadykinesia Akinesia INcoordination (BRAIN) test is a previously validated keyboard tapping test, evaluating proximal upper-limb motor impairment. Here, a new Distal Bradykinesia Tapping (DBT) test was developed to assess distal upper-limb function. Kinetic parameters of the test include kinesia score (KS20, key taps over 20 seconds), akinesia time (AT20, mean dwell-time on each key) and incoordination score (IS20, variance of travelling time between key taps).ObjectiveTo develop and validate a new keyboard-tapping test to assess distal motor function in PD patients.MethodsThe DBT test was validated in 45 PD patients and 24 controls, alongside the BRAIN test. Test scores were compared between groups and correlated with MDS-UPDRS-III scores. 10 additional PD patients were recruited to assess the DBT test in monitoring motor fluctuations.ResultsAll three parameters discriminated between patients and controls, with KS20 performing best, yielding 75% sensitivity for 85% specificity; area under the receiver operating characteristic curve (AUC) = 0.87. Combination of both the DBT and BRAIN tests improved discrimination (AUC=0.91). KS20 and AT20 correlated with MDS-UPDRS-III (Pearson’s r=-0.49, p<0.001 and r=0.54, p<0.001, respectively). The DBT test detected subtle changes in motor fluctuation states, which were not reflected clearly by MDS-UPDRS-III sub-scores.ConclusionThe DBT test is a user-friendly method of assessing distal motor dysfunction in PD, possibly permitting longitudinal monitoring of PD motor complications.

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Validity of the finger tapping test in Parkinson’s disease, elderly and young healthy subjects: Is there a role for central fatigue?

Clinical Neurophysiology ◽

10.1016/j.clinph.2012.04.001 ◽

2012 ◽

Vol 123 (10) ◽

pp. 2034-2041 ◽

Cited By ~ 25

Author(s):

Pablo Arias ◽

Verónica Robles-García ◽

Nelson Espinosa ◽

Yoanna Corral ◽

Javier Cudeiro

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Healthy Subjects ◽

Central Fatigue ◽

Finger Tapping ◽

Finger Tapping Test

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Quantifying upper limb motor impairment in people with Parkinson’s disease: a physiological profiling approach

PeerJ ◽

10.7717/peerj.10735 ◽

2021 ◽

Vol 9 ◽

pp. e10735

Author(s):

Lewis A. Ingram ◽

Vincent K. Carroll ◽

Annie A. Butler ◽

Matthew A. Brodie ◽

Simon C. Gandevia ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Muscle Strength ◽

Upper Limb ◽

Bimanual Coordination ◽

Handgrip Strength ◽

Position Sense ◽

Healthy Controls ◽

Limb Function ◽

Upper Limb Function

Background Upper limb motor impairments, such as slowness of movement and difficulties executing sequential tasks, are common in people with Parkinson’s disease (PD). Objective To evaluate the validity of the upper limb Physiological Profile Assessment (PPA) as a standard clinical assessment battery in people with PD, by determining whether the tests, which encompass muscle strength, dexterity, arm stability, position sense, skin sensation and bimanual coordination can (a) distinguish people with PD from healthy controls, (b) detect differences in upper limb test domains between “off” and “on” anti-Parkinson medication states and (c) correlate with a validated measure of upper limb function. Methods Thirty-four participants with PD and 68 healthy controls completed the upper limb PPA tests within a single session. Results People with PD exhibited impaired performance across most test domains. Based on validity, reliability and feasibility, six tests (handgrip strength, finger-press reaction time, 9-hole peg test, bimanual pole test, arm stability, and shirt buttoning) were identified as key tests for the assessment of upper limb function in people with PD. Conclusions The upper limb PPA provides a valid, quick and simple means of quantifying specific upper limb impairments in people with PD. These findings indicate clinical assessments should prioritise tests of muscle strength, unilateral movement and dexterity, bimanual coordination, arm stability and functional tasks in people with PD as these domains are the most commonly and significantly impaired.

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Opening velocity, a novel parameter, for finger tapping test in patients with Parkinson's disease

Parkinsonism & Related Disorders ◽

10.1016/j.parkreldis.2008.11.003 ◽

2009 ◽

Vol 15 (6) ◽

pp. 440-444 ◽

Cited By ~ 52

Author(s):

M. Yokoe ◽

R. Okuno ◽

T. Hamasaki ◽

Y. Kurachi ◽

K. Akazawa ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Finger Tapping ◽

Finger Tapping Test

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Three-Dimensional Pattern Features in Finger Tapping Test for Patients with Parkinson’s disease

2020 42nd Annual International Conference of the IEEE Engineering in Medicine & Biology Society (EMBC) ◽

10.1109/embc44109.2020.9176652 ◽

2020 ◽

Author(s):

Junjie Li ◽

Huaiyu Zhu ◽

Yun Pan ◽

Haotian Wang ◽

Zhidong Cen ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Three Dimensional ◽

Finger Tapping ◽

Finger Tapping Test

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Sensor Network for Analyzing Upper Body Strategies in Parkinson’s Disease versus Normative Kinematic Patterns

Sensors ◽

10.3390/s21113823 ◽

2021 ◽

Vol 21 (11) ◽

pp. 3823

Author(s):

Paola Romano ◽

Sanaz Pournajaf ◽

Marco Ottaviani ◽

Annalisa Gison ◽

Francesco Infarinato ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Upper Limb ◽

Quantitative Measure ◽

Upper Body ◽

Limb Function ◽

Mean Velocity ◽

Upper Limb Function ◽

Motor Strategy ◽

Block Test

In rehabilitation, the upper limb function is generally assessed using clinical scales and functional motor tests. Although the Box and Block Test (BBT) is commonly used for its simplicity and ease of execution, it does not provide a quantitative measure of movement quality. This study proposes the integration of an ecological Inertial Measurement Units (IMUs) system for analysis of the upper body kinematics during the execution of a targeted version of BBT, by able-bodied persons with subjects with Parkinson’s disease (PD). Joint angle parameters (mean angle and range of execution) and hand trajectory kinematic indices (mean velocity, mean acceleration, and dimensionless jerk) were calculated from the data acquired by a network of seven IMUs. The sensors were applied on the trunk, head, and upper limb in order to characterize the motor strategy used during the execution of BBT. Statistics revealed significant differences (p < 0.05) between the two groups, showing compensatory strategies in subjects with PD. The proposed IMU-based targeted BBT protocol allows to assess the upper limb function during manual dexterity tasks and could be used in the future for assessing the efficacy of rehabilitative treatments.

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Use of a Smartphone to Gather Parkinson’s Disease Neurological Vital Signs during the COVID-19 Pandemic

Parkinson s Disease ◽

10.1155/2021/5534282 ◽

2021 ◽

Vol 2021 ◽

pp. 1-7

Author(s):

Jay L. Alberts ◽

Mandy Miller Koop ◽

Marisa P. McGinley ◽

Amanda L. Penko ◽

Hubert H. Fernandez ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Rating Scale ◽

Vital Signs ◽

Smartphone Application ◽

Finger Tapping ◽

Travel Restrictions ◽

Disease Rating ◽

Smartphone Technology ◽

Finger Tapping Test

Introduction. To overcome travel restrictions during the COVID-19 pandemic, consumer-based technology was rapidly deployed to the smartphones of individuals with Parkinson’s disease (PD) participating in a 12-month exercise trial. The aim of the project was to determine the feasibility of utilizing a combined synchronous and asynchronous self-administered smartphone application to characterize PD symptoms. Methods. A synchronous video virtual visit was completed for the administration of virtual Movement Disorder Society-Unified Parkinson’s Disease Rating Scale III (vMDS-UPDRS III). Participants asynchronously completed a mobile application consisting of a measure of upper extremity bradykinesia (Finger Tapping Test) and information processing. Results. Twenty-three individuals completed the assessments. The mean vMDS-UPDRS III was 23.65 ± 8.56 points. On average, the number of taps was significantly greater for the less affected limb, 97.96 ± 17.77 taps, compared to the more affected, 89.33 ± 18.66 taps (p = 0.025) with a significantly greater number of freezing episodes for the more affected limb ( p < 0.05 ). Correlation analyses indicated the number of errors and the number of freezing episodes were significantly related to clinical ratings of vMDS-UPDRS III bradykinesia (Rho = 0.44, p < 0.01 ; R = 0.43, p < 0.01 , resp.) and finger tapping performance (Rho = 0.31, p = 0.03 ; Rho = 0.32, p = 0.03 , resp.). Discussion. The objective characterization of bradykinesia, akinesia, and nonmotor function and their relationship with clinical disease metrics indicate smartphone technology provides a remote method of characterizing important aspects of PD performance. While theoretical and position papers have been published on the potential of telemedicine to aid in the management of PD, this report translates the theory into a viable reality.

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Validity of a Fully-Immersive VR-Based Version of the Box and Blocks Test for Upper Limb Function Assessment in Parkinson’s Disease

Sensors ◽

10.3390/s20102773 ◽

2020 ◽

Vol 20 (10) ◽

pp. 2773 ◽

Cited By ~ 5

Author(s):

Edwin Daniel Oña ◽

Alberto Jardón ◽

Alicia Cuesta-Gómez ◽

Patricia Sánchez-Herrera-Baeza ◽

Roberto Cano-de-la-Cuerda ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Upper Limb ◽

Manual Dexterity ◽

Clinical Test ◽

Leap Motion ◽

Hand Motion ◽

Upper Limb Function ◽

Classical Procedure ◽

Yahr Scale

In recent decades, gaming technology has been accepted as a feasible method for complementing traditional clinical practice, especially in neurorehabilitation; however, the viability of using 3D Virtual Reality (VR) for the assessment of upper limb motor function has not been fully explored. For that purpose, we developed a VR-based version of the Box and Blocks Test (BBT), a clinical test for the assessment of manual dexterity, as an automated alternative to the classical procedure. Our VR-based BBT (VR-BBT) integrates the traditional BBT mechanics into gameplay using the Leap Motion Controller (LMC) to capture the user’s hand motion and the Oculus Rift headset to provide a fully immersive experience. This paper focuses on evaluating the validity of our VR-BBT to reliably measure the manual dexterity in a sample of patients with Parkinson’s Disease (PD). For this study, a group of twenty individuals in a mild to moderate stage of PD were recruited. Participants were asked to perform the physical BBT (once) and our proposed VR-BBT (twice) system, separately. Correlation analysis of collected data was carried out. Statistical analysis proved that the performance data collected by the VR-BBT significantly correlated with the conventional assessment of the BBT. The VR-BBT scores have shown a significant association with PD severity measured by the Hoehn and Yahr scale. This fact suggests that the VR-BBT could be used as a reliable indicator for health improvements in patients with PD. Finally, the VR-BBT system presented high usability and acceptability rated by clinicians and patients.

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