ASSOCIATION OF GRIP STRENGTH AND MANUAL DEXTERITY WITH PERFORMANCE OF ACTIVITIES OF DAILY LIVING IN PEOPLE WITH PARKINSON'S DISEASE

L. Kurian¹, S.R. Rebello², A.F. D'Souza²

Background: Parkinson's disease (PD) is a common hypokinetic movement disorder characterized by motor symptoms such as tremors, rigidity, and bradykinesia which impair upper extremity function by hindering the performance of repetitive and rhythmic voluntary movements. People with PD often present with muscle weakness and impaired manual dexterity due to impediments in isometric force generation and modulation. Grip strength is considered to be a predictor of health status in PD and has been strongly associated with disease progression. Impaired manual dexterity also gravely affects the quality of hand function in PD. All the aforementioned factors could hypothetically impact the performance of activities of daily living (ADL), putting people with PD at a greater risk for prolonged functional dependence and thereby, a considerably reduced quality of life.

Purpose: To investigate the relationship between grip strength and manual dexterity with the performance of ADL in people with Parkinson’s disease.

Methods: Fifty-nine subjects enrolled in this cross-sectional study. Grip strength was assessed using the Jamar hand dynamometer, nine-hole peg test (9HPT) was used to assess manual dexterity while PROFILE PD was used to assess ADL performance. All outcomes were evaluated bilaterally, data were expressed in terms of hand dominance and correlated using Pearson's correlation coefficient. A p-value ≤ 0.05 was considered statistically significant.

Results: A weak negative correlation was seen between grip strength and PROFILE PD scores on the dominant ( r = -0.2164, p = 0.1 ) and non-dominant side ( r = -0.129, p = 0.33 ) respectively. Whereas, a weak positive correlation was seen between 9HPT and PROFILE PD scores on the dominant ( r = 0.3526, p = 006* ) and non-dominant side ( r = 0.4251, p = 0.000* ) respectively.

Conclusion(s): Although grip strength shows poor association with ADL performance, deficits in manual dexterity can severely impair the performance of ADL in people with Parkinson's disease. Bilateral involvement of the upper extremities leads to greater impairment.

Implications: A detailed functional assessment and evidence-based physiotherapy management of upper extremity function with a focus on improving manual dexterity may promote ADL performance among people with Parkinson's disease. These findings may also guide researchers to develop new interventions for the restoration of upper extremity function in Parkinson's disease.

Funding, acknowledgements: The authors received no financial support for this study.

Keywords: Parkinson's disease, Upper extremity function, Activities of Daily Living

Topic: Neurology: Parkinson's disease

Did this work require ethics approval? Yes

Institution: Father Muller Medical College

Committee: Father Muller Institutional Ethics Committee

Ethics number: FMMC/FMIEC/4107/2017