Objective: To explore the potential use of portable mechanical counters as a simple approach to quantifying finger movement activity in the evaluation of bradykinesia.

Background: Bradykinesia is a hallmark symptom of Parkinson’s disease, typically assessed through clinical observations such as the finger-tapping test. While these methods are routinely used in clinical practice, the assessment remains subjective and can be influenced by inter-rater variability. Various sensor-based digital technologies have been developed to improve the objectivity of movement assessment. However, these devices generally require advanced technology and are not always available across various healthcare settings. Portable mechanical counters commonly used by the public are very low-cost (approximately USD 2–3), widely available across communities, and can be used as a simple, accessible tool for quantifying movement.

Method: A preliminary descriptive study was conducted using portable mechanical counters to record the number of repeated finger taps during a specific measurement period. The recorded tap values were used as quantitative parameters of finger motor activity. Measurements were taken on healthy individuals and individuals with motor disorders to explore differences in movement frequency patterns.

Results: The mechanical counter enabled objective and consistent recording of the number of taps during the examination. Healthy individuals showed a higher tapping frequency than those with Parkinson’s disease. The device is easy to use, portable, and does not require additional digital technology.

Conclusion: The ultra-low-cost mechanical counter has the potential to be a simple, objective approach for quantifying finger tapping activity in the evaluation of bradykinesia. It is easily accessible, highly affordable, and user-friendly, making it a promising candidate for a widely applicable motor screening tool, including in resource-limited settings. This approach shows potential as a very low-cost neurological innovation that could expand access to Parkinson’s motor assessment globally.

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2. Heldman DA, Espay AJ, LeWitt PA, Giuffrida JP. Clinician versus machine: reliability and responsiveness of motor endpoints in Parkinson’s disease. Parkinsonism & Related Disorders. 2014;20(6):590–595.
3. Mera TO, Heldman DA, Espay AJ, Payne M, Giuffrida JP. Feasibility of home-based automated Parkinson’s disease motor assessment. Journal of Neuroscience Methods. 2012;203(1):152–156.
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MDS Abstracts - https://www.mdsabstracts.org/abstract/can-prayer-beads-quantify-bradykinesia-an-ultra-low-cost-approach-to-motor-assessment-in-parkinsons-disease/