Objective: To examine the relationship between upper extremity function and the Movement Disorders Society-Unified Parkinson’s Disease Rating Scale part III (MDS-UPDRS-III) for use as a clinical tool for quantifying upper extremity function in patients with Parkinson’s disease (PD).

Background: Due to the parkinsonism, many people with PD have compromised function of upper extremities, affecting reaching, grasping, and object manipulation. However, the relationship between the severity of parkinsonism and upper extremity function in PD remains unclear.

Method: We enrolled 53 patients with PD (21 men and 32 women, average age: 74.4 ± 6.9 years, average Hoehn-Yahr scale: 2.5 ± 0.8, average disease duration: 4.9 ± 4.4 years). Subjects were excluded from the study if they had a history of any other known neurologic or orthopedic disorder that could affect functional activity. Upper extremity function was evaluated using the Simple Test for Evaluating Hand Function (STEF). The severity of parkinsonism was assessed using the upper limb and posture items of MDS-UPDRS-III during the ‘on’ state of PD. Data were analyzed using SPSS (version 25.0). Wilcoxon signed-rank test revealed no significant difference in function between the dominant and non-dominant hands (p= 0.11); therefore, the value for the dominant hand was used in this study. Spearman’s rank correlation coefficient was used to quantify bivariate associations between the MDS-UPDRS-III and STEF.

Results: STEF scores were significantly negatively correlated with MDS-UPDRS-III scores with respect to hand movements (p= 0.002), global spontaneity of movement (p= 0.007), rigidity of upper extremity (p= 0.02), finger tapping (p= 0.026), and pronation-supination movements of hands (p= 0.027). However, no correlations were found with rigidity of the neck (p= 0.151), postural stability (p= 0.204), posture (p= 0.939), rest tremor amplitude of upper extremity (p= 0.116), postural tremor of the hands (p= 0.128), kinetic tremor of the hands (p= 0.416), or constancy of rest tremor (p= 0.644).

Conclusion: Upper extremity function in PD patients is related to limb bradykinesia, akinesia and rigidity; this information can help in goal-setting in rehabilitation.

References: 1) Goetz CG, Tilley BC, Shaftman SR, et al. Movement Disorder Society-sponsored revision of the Unified Parkinson’s disease Rating Scale (MDS-UPDRS): scale presentation and clinimetric testing results. Mov Disord; 2008: 23: 2129-2170. 2) Dickson DW. Parkinson’s disease and parkinsonism: Neuropathology. Cold Spring Harb Perspect Med; 2012; 2: a009258. 3) Mateos-Toset S, Cabrera-Martos I, Torres-Sanchez I, et al. Effects of a Single Hand Exercise Session on Manual Dexterity and Strength in Persons with Parkinson Disease: A Randomized Controlled Trial. PM R 2016; 8: 115-122. 4) Hwang W, Hwang S, Lee K, et al. Relationships between upper extremity performance and unified Parkinson’s disease rating scale-motor exam. Phys Ther Rehabil Sci 2013; 2: 99-103.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/relationship-between-parkinsonism-and-upper-extremity-function-in-patients-with-parkinsons-disease/