Objective: The present study aimed to examine the effect of functional training on enhancing the gross and fine upper limb extremity function in people with PD.

Background: People with PD manifest upper limb function and dexterity impairments which contribute to the burden of their daily life [1-2]. To our knowledge, there is limited research that reported the effects of minimally supervised functional training program on improving the upper limb function and dexterity.

Method: This study was a randomized control trial. People with PD were recruited from a patients’ self-help group and were randomly allocated into an upper limb (UL) group or a control group. Participants in UL group received upper limb and dexterity training including stretching, strength training, and dexterity training. The control group received walking training. Both experimental groups received a total of 6 months of training, with 10 training sessions supervised by physiotherapists. Jebsen-Taylor Hand Function test [3] and Purdue Pegboard test [4] were conducted at baseline and after completion of 6 months of training. Independent t-test or Mann Whitney U test were used to examine if there was significant difference between the subject groups.

Results: A total of 32 participants in the UL group (mean age = 63.7±8.1 years) and 41 participants in the control group (mean age = 60.9±7.2 years) completed the study. After 6 months of training, both subject groups significantly reduced the time taken to complete Jebsen-Taylor Hand Function Test and increased the number of pegs for the Purdue Pegboard test. Between-group comparison found that participants of the UL group demonstrated marginal improvement for the Jebsen-Taylor Hand Function Test when compared with the control group (UL: -16.8±19.1s and CON: -7.7±22.8s, P = 0.076).

Conclusion: Both subject groups showed improvements in upper extremity function after training, and the UL group was marginally better than the control group for the Jebsen-Taylor Hand Function Test score. Home-based training may not be an effective method to enhance upper extremity functions for people with PD.

References: [1] Pohar, S. L., & Jones, C. A. (2009). The burden of Parkinson disease (PD) and concomitant comorbidities. Archives of Gerontology and Geriatrics, 49(2), 317-321. [2] Van der Marck, M. A., Kalf, J. G., Sturkenboom, I. H., Nijkrake, M. J., Munneke, M., & Bloem, B. R. (2009). Multidisciplinary care for patients with Parkinson’s disease. Parkinsonism & Related Disorders, 15, S219-S223. [3] Mak, M. K. Y., Lau, E. T. L., Tam, V. W. K., Woo, C. W. Y., & Yuen, S. K. Y. (2015). Use of Jebsen Taylor Hand Function Test in evaluating the hand dexterity in people with Parkinson’s disease. Journal of hand therapy, 28(4), 389-395. [4] Proud, E. L., & Morris, M. E. (2010). Skilled hand dexterity in Parkinson’s disease: effects of adding a concurrent task. Archives of Physical Medicine and Rehabilitation, 91(5), 794-799.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/effect-of-home-based-functional-training-program-on-enhancing-gross-and-fine-upper-extremity-function-in-people-with-parkinsons-disease-a-randomized-controlled-trial/