Objective: To establish the validity of an upper extremity kinesiological assessment in patients with Parkinson’s disease as a complementary tool to clinical instruments.

Background: Parkinson’s disease (PD) is a degenerative disorder that impacts various aspects of a patient’s life, especially motor function and independence. The functional evaluation mainly relies on clinical tools (Hoehn & Yahr and MDS-UPDRS), which are susceptible to human error. The emergence of new technologies like kinesiological assessment enables a more precise evaluation of these patients and could be a complementary tool.

Method: Demographic and clinical assessments were used for pairing controls and subjects with PD. Six movements were selected from MDS-UPDRS to be performed (pressing buttons [Bs: 3cm; Bb: 19.8cm], lifting objects [obj1: 24g; obj2: 546g], prono-supination of the arm). Movements were evaluated by time and number of repetitions. Reflective markers (14mm in diameter) were placed on the body, following the Plug-in Gait Upper Body model, and movements were captured using a Vicon® system with Nexus, an inertial sensor (Trident Vicon) on the back of the hand.

Results: The subject with PD demonstrated greater speed when moving obj1 and obj2, while the jerk (or pull; a derivative of acceleration) was 72% greater for obj1 in the control subject (Graphic1). For prono-supination at 90 degrees, the control subject exhibited a difference of 104% greater jerk, and the joint RoM was lower by 13º. While no differences in speed were observed when pressing the Bb buttons, the subject with PD exhibited a 69% increase in jerk, which was also elevated for the Bs. Superficial electromyography showed different muscle activation patterns (MAP) (Image1). The patient with Parkinson’s disease showed a persisting contraction of the flexor digitorum profundus during the button tasks compared to the healthy patient who showed only activation during movement, and a decreased muscle activity of the biceps (PD) when lifting the full can. No differences were found in joint goniometry across any of the evaluations.

Conclusion: Kinematic parameters such as velocity and jerk, in addition to the different MAP, show a significant difference between the PD patient and healthy control, making this evaluation a promising tool for further development.

Graphic 1. Jerk in PD vs healthy control subjects.

Image 1. Significant MAP in sEMG

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MDS Abstracts - https://www.mdsabstracts.org/abstract/validation-of-a-quantitative-test-using-kinesiological-evaluation-of-upper-extremity-movements-in-patients-with-parkinsons-disease-a-pilot-study/