Objective: To review the effectiveness and describe the exercise parameters of interventions targeting upper limb (UL) function in people with PD.

Background: Reduced fine hand skills can impact on the ability of people with PD to carry out their daily activities (1). Despite the prevalence of these functional limitations, there is limited information to guide UL exercise interventions in clinical practice and research.

Methods: A systematic review was conducted in February 2018, according to PRISMA guidelines. We searched 5 databases (MEDLINE Ovid, CINAHL, PEDro, PubMed, Cochrane Database), and hand searched relevant systematic reviews and reference lists. Inclusion criteria were full text English reports with 1) participants with Parkinson’s disease, 2) an active movement/exercise intervention, 3) an aim to improve UL function and 4) UL activity/participation outcome measures. Single case studies (n=1) were excluded.

Results: Eight articles were identified; six of the eight studies were RCTs of varying quality. Most of the 369 unique study participants had mild to moderate PD (HY I-III). Interventions were largely home-based, with content varying from standardized exercises to individualized programs with tailoring and progression. Program duration ranged from 2 to 24 weeks. Outcome measures included: standardized dexterity tests, such as the 9-Hole Peg Test; handwriting assessments; and self-reported UL performance questionnaires. Four RCTs that trained 1) task-specific dexterity, 2) sensory-motor function, 3) handwriting amplitude, and 4) a combination of writing and dexterity, found significant between-group differences in improvements in UL function favoring their intervention groups.

Conclusions: A variety of interventions were delivered to improve UL function in people with PD. The results of this review are encouraging, and suggest that exercise incorporating task-related practice may improve UL function in people with PD.

References: 1. Raggi et al., (2011). Disability and profiles of functioning of patients with Parkinson’s disease described with ICF classification. International Journal of Rehabilitation Research. 34:141-50.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/exercise-to-improve-upper-limb-function-in-people-with-parkinsons-disease-a-systematic-review/