Repetitive finger movement and circle drawing in persons with Parkinson's disease.

Elizabeth L Stegemöller,Andrew Zaman,Jennifer Uzochukwu,J Lucas Mckay

doi:10.1371/journal.pone.0222862

Elizabeth L Stegemöller, Andrew Zaman + Show 2 more

Open Access

https://doi.org/10.1371/journal.pone.0222862

Copy DOI

Abstract

Little is known regarding how repetitive finger movement performance impacts other fine motor control tasks, such as circle drawing, in persons with Parkinson’s disease (PD). Previous research has shown that impairments in repetitive finger movements emerge at rates near to and above 2 Hz in most persons with PD. Thus, the purpose of this study was to compare circle drawing performance in persons with PD that demonstrate impairment in repetitive finger movement and those that do not. Twenty-two participants with PD and twelve healthy older adults completed the study. Only participants with PD completed the repetitive finger movement task. From the kinematic data for the repetitive finger movement task, participants were grouped into Hasteners and Non-Hasteners. Participants with PD and the healthy older adults completed a series of circle drawing tasks at two different target sizes (1 cm and 2 cm) and three pacing conditions (Self-paced, 1.25 Hz, and 2.5 Hz). Kinematic and electromyography data were recorded and compared between groups. Results revealed that, in general, persons with PD demonstrate impairments in circle drawing and associated electromyography activity compared to healthy older adults. Moreover, persons with PD that hasten during repetitive finger movements demonstrate significantly increased movement rate during circle drawing, while those persons with PD that do not hasten demonstrate a significant increase in width variability. This suggests that differing motor control mechanisms may play a role in the performance of fine motor tasks in persons with PD. Continued research is needed to better understand differences in circle drawing performance among persons with PD to inform future development of patient-centered treatments.

Highlights

Research has shown that persons with Parkinson’s disease (PD) demonstrate impairments in fine motor tasks, such as writing tasks
Hastener and non-hastener groups did not differ in which side of the body was more affected by PD (p = 0.15)
The results suggest that, in general, persons with PD demonstrate differences in circle drawing and associated EMG activity compared to HOAs

Summary

Introduction

Research has shown that persons with Parkinson’s disease (PD) demonstrate impairments in fine motor tasks, such as writing tasks. Handwriting and circle drawing are small, slow, and often illegible [1,2,3,4,5] These changes in writing may be a consequence of other PD symptoms such as tremor, rigidity, or bradykinesia, slowness of movement. Bradykinesia may have the greatest impact on functional disability in persons with PD [6,7]. While repetitive movements, such as finger tapping, are used in the clinical assessment of bradykinesia, there is no assessment of other fine motor tasks on the motor Unified Parkinson’s Disease Rating.

Objectives

Methods

Results

Discussion

Conclusion