Introduction: Dual-task interference (DTI) leads to impairment of hand dexterity in Parkinson's disease (PD). The performance of activities of daily living (ADL) is negatively affected by dexterity in PD. However, the contribution of DTI to dexterity-related ADL disability remains unclear. This cross-sectional study aimed to investigate the contribution of DTI to ADL performance as well as other factors affecting dexterity.
Methods: One-hundred and eight patients with PD were assessed using the ADL-related dexterity questionnaire-24 to measure dexterity-related ADL performance. Performance in single and dual task conditions was measured with the 9-hole peg test. Disease severity, cardinal symptoms and grip strength were assessed using Hoehn&Yahr, a modified version of the Unified Parkinson Disease Rating Scale, Part-III, and a hand dynamometer. The age and cognitive status were control variables.
Results: Multiple regression analysis revealed that disease severity explained 8.5% of the variance in dexterity-related ADL (p = 0.002). The DTI in the dominant hand was the strongest predictor of ADL performance (R change = 0.44, p < 0.001), but DTI in the non-dominant hand did not contribute. When cardinal symptoms were added to the model, bradykinesia contributed to ADL difficulty (R change = 0.072, p < 0.001), while tremor and rigidity were not significant in any model. This model accounted for 59.2% of the variance in ADL difficulties in total.
Conclusion: The study demonstrated that disease severity, bradykinesia and DTI in the dominant hand contributed to ADL difficulties in patients with PD, and DTI in the dominant hand is the strongest predictor of ADL performance in PD.
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http://dx.doi.org/10.1016/j.parkreldis.2019.07.017 | DOI Listing |
Can J Neurol Sci
May 2024
Department of Physical Therapy & Assistive Technology, National Yang Ming Chiao Tung University, Taipei, Taiwan.
Objectives: This systematic review primarily aims to identify the optimal physiotherapeutic intervention to improve hand dexterity in Parkinson's Disease (PD) patients. The secondary objectives were to identify the hand dexterity physiotherapeutic interventions available for PD patients, and to determine the quality of these interventions.
Review Methods: Eight electronic databases were systematically searched to identify relevant randomized controlled trial full-text articles using the established search strategy.
J Neuroeng Rehabil
January 2023
Neurocenter, Luzerner Kantonsspital, Lucerne, Switzerland.
Background: Persons with Parkinson's disease (PD) often exhibit difficulties with dexterity during the performance of activities of daily living (ADL), inter alia due to dysfunctional supplementary motor area (SMA). Combined intermittent theta-burst stimulation (iTBS) over the SMA followed by video game-based training (VBT) may therefore improve dexterity related ADL. The VBT may induce high flow levels related to high performance during the training.
View Article and Find Full Text PDFParkinsonism Relat Disord
September 2019
Department of Neurology, Faculty of Medicine, Ordu University, Turkey.
Introduction: Dual-task interference (DTI) leads to impairment of hand dexterity in Parkinson's disease (PD). The performance of activities of daily living (ADL) is negatively affected by dexterity in PD. However, the contribution of DTI to dexterity-related ADL disability remains unclear.
View Article and Find Full Text PDFParkinsonism Relat Disord
August 2017
Neurocenter, Luzerner Kantonsspital, Switzerland.
Background: Patients with Parkinson's disease exhibit disturbed manual dexterity. This impairment leads to difficulties in activities of daily living, such as buttoning a shirt or hand-writing. The aim of the present study was to investigate the effectiveness of a home-based dexterity program on fine motor skills in a single-blinded, randomized controlled trial, in patients with Parkinson's disease.
View Article and Find Full Text PDFMult Scler
October 2015
Department of Neurology, Inselspital, Bern University Hospital, and University of Bern, Switzerland/Neurology and Neurorehabilitation Center, Luzerner Kantonsspital, Switzerland.
Background: Impaired manual dexterity is frequent and disabling in patients with multiple sclerosis (MS), affecting activities of daily living (ADL) and quality of life.
Objective: We aimed to evaluate the effectiveness of a standardized, home-based training program to improve manual dexterity and dexterity-related ADL in MS patients.
Methods: This was a randomized, rater-blinded controlled trial.
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