Without visual guidance, patients with Parkinson disease had more difficulty in perceiving the extent of a movement made to a target away from the body, a task requiring reliance on proprioceptive feedback. Parkinsonian patients had no more difficulty than controls in making movements to a target on the surface of the body when they could use tactile sensations. Movement difficulties in patients with Parkinson disease may relate in part to a decrease in proprioception. Activities that enhance kinesthetic awareness may be an important adjunct to the treatment of these patients.

The 14-item FIST is reliable and valid in adults following acute stroke. Studies of intra- or intertester reliability and evaluative validity studies including applications to other patient populations with sitting balance dysfunction are now necessary.

Musicians. keyboard operators, data entry clerks, writers, and assembly workers perform repetitive, rapid, alternating movements of the fingers or maintained fine motor movements of the fingers under conditions of high demand and high productivity (6,18,42). These workers are at risk to develop musculoskeletal problems, including tendinitis, fascitis, and postural strain, or neurological problems, such as neuritis, nerve entrapments, or occupational hand cramps (6,9,18,22,42). These types of cumulative trauma syndromes are reaching epidemic levels in the work force and are costing millions of dollars despite management concern and ergonomic changes (6).Rapid repetitive movements under high levels of tension and force can interfere with the circulation and deprive the tissues of oxygen, leading to pain, inflammation, and muscle spasm (18.42). Although the body will naturally attempt to repair the tissues, other factors seem to increase the risk for continued symptoms (9,51,57).