Functional Skills, Muscle Strength Development, PARKINSON DISEASE (Disorder), Upper Extremity
Conditions
Brief summary
Parkinson's disease (PD) is the second most common neurodegenerative disease, characterized pathologically by the progressive loss of dopaminergic neurons in the substantia nigra and clinically by the presence of motor symptoms such as bradykinesia, resting tremor, and/or rigidity.Patients with Parkinson's disease (pwPD) often exhibit poor manual dexterity and decreased strength. Fine motor deficits seen in PD include an inability to control cognitive power/force, poor manual dexterity, and motor dysfunction, which includes difficulties achieving the angles, speed, and coordination required for basic movements. Anatomical strength, as detailed in activities of daily living (ADL), is an important indicator of motor characteristics and vitality.Studies have shown a strong relationship between postural control and fine motor functions. For high-quality distal movement, better proximal stabilization is necessary. During upper extremity functions, the body's center of gravity must shift with arm movements, allowing adaptation to changing gravity. Good trunk control is essential in this dynamic process of maintaining balance. Studies examining this link between trunk control, balance, and hand functions are available in the literature. Among these studies conducted in diverse populations, studies involving PD are very few. Investigating parameters such as grip strength, upper extremity dexterity, and reaction time in PD will fill the gap in the literature. Meta-analysis studies have shown that muscle strength and strength in individuals with PD are lower than in healthy individuals. Furthermore, muscle strength in PD has been shown to be related to functional capacity and disease severity. In light of all this information, our study was designed to investigate the relationship between upper body muscle strength, particularly proximal and distal, and manual dexterity in PD. In this direction, the aim of this study is to determine the relationship between proximal and distal muscle strength and upper extremity functional abilities in PD.
Interventions
None listed
Sponsors
Kahramanmaras Sutcu Imam University
Study design
Observational model
CASE_CONTROL
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
40 Years to 75 Years
Healthy volunteers
Yes
Inclusion criteria
* Healthy individuals aged 40-75 years, diagnosed with idiopathic PD according to the UK Parkinson's Disease Association Brain Bank criteria by a specialist neurologist, with a Modified Hoehn & Yahr (m-HY) scale stage ≤4, and with a Mini Mental State Examination score of ≥22 for those with training and ≥18 for those without training, and with no known disease, volunteered to participate in the study. * Individuals with no other known neurological and/or systemic disease * Individuals without any upper extremity contractures
Exclusion criteria
* Individuals with diagnosed and/or treated psychiatric illnesses who are considered unable to complete the tests. * Those taking neuroleptic medications or antidepressants. * Individuals with orthopedic conditions that interfere with manual dexterity tests, such as severe dyskinesia, carpal tunnel syndrome, tendon injuries, or finger amputations; rheumatological conditions such as rheumatoid arthritis and osteoarthritis; and individuals with any neurological condition other than PD.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Muscle Strength Measurement | first day of assesment | The isometric strength measurement will be performed using a digital muscle strength measurement device (KFORCE KINVENT) for the bilateral serratus anterior, upper trapezius, latissimus dorsi, deltoid, supraspinatus, teres minor, subscapularis, and biceps brachii muscles of the upper extremity. |
| Grip Strength Measurement | first day of assesment | A Jamar hand dynamometer (Baseline®) and a PinchMeter (Baseline Mechanical Pinch Gauge with Case, Blue, 30 lb) will be used for grip strength measurement.The isometric strength measurement will be performed using a digital muscle strength measurement device (KFORCE KINVENT) for the bilateral serratus anterior, upper trapezius, latissimus dorsi, deltoid, supraspinatus, teres minor, subscapularis, and biceps brachii muscles of the upper extremity. Grip Strength Measurement: A Jamar hand dynamometer (Baseline®) and a PinchMeter (Baseline Mechanical Pinch Gauge with Case, Blue, 30 lb) will be used for grip strength measurement. |
| The 9-Hole Peg Test (DDPT) | first day of assesment | The 9-Hole Peg Test (DDPT) is a validated test for PD that measures manual dexterity in seconds based on performance. The test material consists of nine standard-sized small rods and a nine-hole platform. The test will be administered with the patient in a seated position. The patient will be asked to place nine rods in the round compartment of the box as quickly as possible into the holes of the box, starting from the edge farthest from the compartment. Once completed, immediately remove them from the compartment, starting from the edge closest to the compartment. The test will begin with the dominant hand, and the time will be measured with a stopwatch. The time will begin when the hand touches the rods and will end when the last rod is placed in the box. The same procedure will be applied to the other hand. In this study, the arithmetic average of the test times, repeated twice, will be recorded separately for each hand. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Demographic Form | first day of assesment | (Medical history (disease duration and symptoms), demographic information (age, height, weight, education level), habits, medications, level of dependency in mobility in daily life, use of assistive devices) |
| Mini Mental State Examination (MMSE) | first day of assesment | This test was developed by Folstein in 1975. Its Turkish validity and reliability study was conducted by Güngen et al. in 2002 (18). The Mini Mental State Examination (MMSE), which is quite suitable for screening cognitive function in the elderly and assesses cognitive functions in five separate areas (orientation, registration, attention and calculation, recall, and language), is frequently used. A score below 24 on the MMSE indicates dementia, 24-26 indicates mild cognitive impairment, and 26 or above indicates normal cognitive function. |
| Modified Hoehn & Yahr (m-HY) scale | first day of assesment | PD disability will be assessed with the m-HY scale: stage 1.0 (unilateral involvement only); stage 1.5 (unilateral and axial involvement); stage 2.0 (bilateral involvement without balance impairment); stage 2.5 (mild bilateral disease with improvement in the pull test); stage 3.0 (mild to moderate bilateral disease; some postural impairment; physically independent); stage 4.0 (severe disability; still able to walk or stand unaided). Symptom severity in PD was graded using the Unified Parkinson's Disease Rating Scale (UPDRS): part I (mental dysfunction and mood); part II (activities of daily living); part III (motor component); part IV (treatment-related complications) |
| Unified Parkinson's Disease Rating Scale (UPDRS) | first day of assesment | Symptom severity in PD is rated using the Unified Parkinson's Disease Rating Scale (UPDRS). Several items on this scale assess upper extremity and hand function. The Activities of Daily Living section assesses handwriting, cutting food, and grasping utensils. The Motor section assesses finger tapping, hand movements, and rapid alternating hand movements. These test items are scored from 0 to 4, with 4 representing maximum impairment and 0 representing normal movement ability. The UPDRS is comprised of subsections: Section I (mental dysfunction and mood); Section II (activities of daily living); Section III (motor); and Section IV (treatment-related complications). |
Countries
Turkey (Türkiye)
Outcome results
None listed