Home based training for dexterity in Parkinson's disease: A randomized controlled trial

Vanbellingen, Tim; Nyffeler, Thomas; Nigg, Julia; Janssens, Jorina; Hoppe, Johanna M.; Nef, Tobias; Müri, René M.; Wegen, Erwin E. H. van; Kwakkel, Gert; Bohlhalter, Stephan

doi:10.1016/j.parkreldis.2017.05.021

Cited by 56 publications

(71 citation statements)

References 30 publications

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“…With respect to fine motor skills, PwPD performed significantly worse in the NHPT as compared to controls. This is well in line with impaired dexterity due to PD [ 34 ]. In contrast, despite a general trend towards lower amplitudes and speed in PwPD, group differences in the tablet-based tests of drawing and writing did not survive correction for multiple comparisons.…”

Section: Discussionsupporting

confidence: 72%

LSVT-BIG therapy in Parkinson’s disease: physiological evidence for proprioceptive recalibration

Peterka

Odorfer

Schwab³

et al. 2020

BMC Neurol

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Background There is growing evidence for proprioceptive dysfunction in patients with Parkinson’s disease (PD). The Lee Silvermann Voice Treatment-BIG therapy (LSVT-BIG), a special training program aiming at an increase of movement amplitudes in persons with PD (PwPD), has shown to be effective on motor symptoms. LSVT-BIG is conceptionally based on improving bradykinesia, in particular the decrement of repetitive movements, by proprioceptive recalibration. Objective To assess proprioceptive impairment in PwPD as compared to matched controls and to probe potential recalibration effects of the LSVT-BIG therapy on proprioception. Methods Proprioceptive performance and fine motor skills were assessed in 30 PwPD and 15 matched controls. Measurements with significant impairment in PwPD were chosen as outcome parameters for a standardized 4 weeks amplitude-based training intervention (LSVT-BIG) in 11 PwPD. Proprioceptive performance served as primary outcome measure. Secondary outcome measures included the motor part of the MDS-UPDRS, the nine-hole-peg test, and a questionnaire on quality of life. Post-interventional assessments were conducted at weeks 4 and 8. Results Compared to the control group, PwPD showed significantly larger pointing errors. After 4 weeks of LSVT-BIG therapy and even more so after an additional 4 weeks of continued training, proprioceptive performance improved significantly. In addition, quality of life improved as indicated by a questionnaire. Conclusion LSVT-BIG training may achieve a recalibration of proprioceptive processing in PwPD. Our data indicates a probable physiological mechanism of a symptom-specific, amplitude-based behavioral intervention in PwPD.

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Section: Discussionsupporting

confidence: 72%

LSVT-BIG therapy in Parkinson’s disease: physiological evidence for proprioceptive recalibration

Peterka

Odorfer

Schwab³

et al. 2020

BMC Neurol

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“…The opportunity for feedback and encouragement periodically has been related to home‐based patient compliance . In this way, the ability for care providers to monitor upper limb functioning via the Internet gives patients a consistent follow‐up through the therapeutic process that may help to increase their adherence to home exercise programs, which have proven to be effective for upper limb disturbances . The main concern is that individuals with PD are likely to be older and less technologically adept, and to have cognitive or physical limitations that make interaction with a telemedicine platform more difficult .…”

Section: Discussionmentioning

confidence: 99%

Agreement Between Face‐to‐Face and Tele‐assessment of Upper Limb Functioning in Patients with Parkinson Disease

Cabrera‐Martos

Ortíz‐Rubio

Torres‐Sánchez

et al. 2019

PM&R

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Background: Upper limb disturbances are prevalent in patients with Parkinson disease (PD) and can limit their participation in activities of daily living. Tele-assessment of upper limb motor symptoms using an Internet application may be an alternative for addressing the growing demand for monitoring of disease progression. Objective: To evaluate the level of agreement between face-to-face and tele-assessment of patients with PD. Design: Reliability study. Setting: Parkinson's Disease Association. Participants: Twenty-one patients with PD from a local association participated in the study. Methods: Patients attended a session for clinical face-to-face and real-time online tele-assessment. Main Outcome Measurements: Upper limb measures of function (assessed with the Manual Ability Measure 16), dexterity (evaluated using the coin rotation task), motor speed (assessed by the finger tapping test), tremor (evaluated with the Fahn-Tolosa-Marin Tremor Rating Scale), and range of motion (using the Kinovea software) were recorded by two independent researchers. Results: All the outcome measures evaluated showed a good interrater, intraclass correlation coefficient (ρ > 0.75). In addition, most confidence intervals were narrow and excluded 0.8. The lowest reliability was obtained for elbow flexion of the most affected upper limb (ρ = 0.75; confidence interval 0.49-0.89) and the highest reliability for finger tapping tests (ρ = 1; 1, 1). Conclusions: This study demonstrates high interrater reliability of upper limb tele-assessment in patients with PD compared to a face-to-face assessment.

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“…Our findings clearly favor the concept that LKA accounts for dexterous impairment beyond parkinsonian symptoms, a controversial debate that started a decade ago. 19,20 Because dopaminergic treatment only minimally improves LKA, 1 nonpharmacologic treatment options, such as noninvasive, repetitive brain-stimulation techniques 21,22 or specific home-based dexterity training, 23 may offer an improvement in dexterous functions for patients with PD.…”

Section: Discussionmentioning

confidence: 99%

Limb Kinetic Apraxia Is an Independent Predictor for Quality of Life in Parkinson's Disease

Vanbellingen

Hofmänner

Kübel

et al. 2018

Movement Disord Clin Pract

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Background Impaired dexterity is a common symptom in Parkinson's disease (PD) and has been related to limb kinetic apraxia (LKA). LKA negatively influenced activities of daily living (ADL) in PD. However, the impact on quality of life (QoL) remains to be clarified, which was the aim of the current study. Methods Eighty nondemented patients with PD and 60 age‐matched, sex‐matched healthy individuals participated in this study. The 39‐item Parkinson's Disease Questionnaire was used to measure QoL. Dexterity was assessed by the coin rotation (CR) task and the ADL‐related Dexterity Questionnaire 24. Nonmotor symptoms were monitored with part I of the Movement Disorder Society‐Unified Parkinson's Disease Rating Scale, and motor symptoms were measured with parts II and III of the modified Movement Disorder Society‐Unified Parkinson's Disease Rating Scale. Results Regression analysis revealed that dexterity scores controlled for parkinsonian motor symptoms were a strong and independent predictor of QoL in patients with PD. Conclusion The study demonstrated that the strong association of impaired dexterity and QoL is independent of bradykinesia, thereby underscoring the clinical relevance of LKA in PD.

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Home based training for dexterity in Parkinson's disease: A randomized controlled trial

Cited by 56 publications

References 30 publications

LSVT-BIG therapy in Parkinson’s disease: physiological evidence for proprioceptive recalibration

LSVT-BIG therapy in Parkinson’s disease: physiological evidence for proprioceptive recalibration

Agreement Between Face‐to‐Face and Tele‐assessment of Upper Limb Functioning in Patients with Parkinson Disease

Limb Kinetic Apraxia Is an Independent Predictor for Quality of Life in Parkinson's Disease

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