Objective: To describe grip strength and upper limb (UL) distress in de novo PD, and to explore associations with motor symptoms.

Background: Grip strength is linked to vitality in older adults and is an essential aspect of hand motor control [1,2]. Reduced finger dexterity is common, often unilaterally in early PD, but a recent review report inconsistency in grip strength outcomes [3]. Hand deformities, cramps and pain, are also repoted [4, 5], yet UL distress and grip strength in de novo PD are barely explored.

Method: Sixty‑seven persons with de novo PD [mean (SD) age 67 (10.7) years, 28 (42%) females] were assessed with Jamar Hand Dynamometer (JHD) and UPDRS III. UL distress (self-reported hand deformities, cramps, and pain) was evaluated with a researcher-developed questionnaire. The more and less affected UL were defined by higher UPDRS III UL scores. Normative mean values of JHD, stratified by age, sex, and hand dominance [6], were used to calculate a percentage below the mean and the corresponding absolute value (kg). Linear regression analyses estimated the impact of the total UPDRS III score on JHD results (dependent variable) for each hand separately, and on UL distress. All models were adjusted for age and sex.

Results: Median (q1–q3; min–max) UPDRS III was 21 (15–28; 8–53). Mean (SD; min–max) JHD in the more and less affected hand was 29.3 kg (10.6; 12–60) and 31.7 kg (9.9; 15–65), respectively. Thirty‑two participants (48%) showed grip strength on average 3.4 kg below normative mean values in the more affected hand, while twenty-five (37%) showed a mean deficit of 2.1kg in the less affected hand. The corresponding mean values within each deficit group were 7.0 kg and 5.5 kg, respectively. Twenty‑six (39%) reported UL distress. Each one‑point increase in UPDRS III was significantly associated (p≤0.036) with reduced grip strength in both more and less affected hand (B; 95% CI –0.32; –0.51 to –0.13 and –0.18; –0.36 to –0.01 respectively). No significant associations were found between UL distress and UPDRS III.

Conclusion: In de novo PD, grip strength is bilaterally reduced and related to general motor symptoms. UL distress, reported by over a third, shows no link to motor symptoms – a relationship larger multicenter trials could clarify. Given PD´s progressive nature, grip strength and UL status should be monitored from the disease onset and evaluated through the PD-course to guide treatment.

References: 1. Vaishya R, Misra A, Vaish A, Ursino N, D’Ambrosi R. Hand grip strength as a proposed new vital sign of health: a narrative review of evidences. J Health Popul Nutr. 2024;43(1):7.
2. Hamill J, Knutzen K, Derrick T. Biomechanical Basis of Human Movement. Fith ed. Philadelphia, PA: Lippincott Williams & Wolters Kluwer business.; 2021.
3. Mazza R, Lemos Silva AE, Telles Machado L, da Silva Rocha Paz T, Correa CL. Handgrip strength in Parkinson´s disease: A systematick review of observational studies. . Fisioter Mov. 2024;37:e37203.
4. Brogren E, Dahlin LB, Franzen E, Lindholm B. Striatal Hand Deformities in Parkinson’s Disease: Hand Surgical Perspectives. Mov Disord Clin Pract. 2022;9(8):1047-54.
5. Mammen JR, Speck RM, Stebbins GT, Muller M, Yang PT, Campbell M, et al. Relative Meaningfulness and Impacts of Symptoms in People with Early-Stage Parkinson’s Disease. J Parkinsons Dis. 2023;13(4):619-32.
6. Mathiowetz V, Kashman N, Volland G, Weber K, Dowe M, Rogers S. Grip and pinch strength: normative data for adults. Arch Phys Med Rehabil. 1985;66(2):69-74.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/grip-strength-and-hand-distress-in-de-novo-parkinsons-disease-support-for-early-rehabilitation/