Patient Perspectives on Upper-Limb Daily Function in Parkinson's Disease

Area of Science:

• Neurology
• Rehabilitation Science
• Occupational Therapy

Background:

• Dexterity impairments significantly affect people with Parkinson's disease (PWP).
• The impact of upper-limb (UL) dysfunction on daily activities in PWP is not well understood.
• Identifying specific dexterity challenges is key to improving PWP's functional independence.

Purpose of the Study:

• To identify dexterity activities most impacted and meaningful for PWP.
• To explore correlations between perceived dexterity and disease severity, cognitive/motor impairments, dexterity ability, ADL function, and quality of life (QOL).
• To determine factors influencing perceived dexterity and examine differences based on affected dominance.

Main Methods:

• 43 PWP (mean age 70) were assessed using the Dexterity Questionnaire (DextQ-36), Coin Rotation Task, Hoehn and Yahr Scale, MDS-UPDRS, MoCA, and PDQ-39.
• Evaluated perceived dexterity, dexterity ability, disease severity, UL motor impairments, cognition, and QOL.
• Data analysis explored associations and explanatory variables for perceived dexterity.

Main Results:

• Difficult and meaningful dexterity tasks included using touchscreens, dressing, and dialing phones.
• Perceived dexterity strongly correlated with ADL function (r=0.716), QOL (r=0.691), disease severity (r=0.470), and dominant-hand dexterity (r=0.432).
• Dexterity ability and disease severity explained 30% of perceived dexterity variance; no differences were found based on dominance affectedness.

Conclusions:

• PWP face significant challenges in complex dexterity tasks, impacting their independence.
• Clinical assessments for PWP should incorporate questions about meaningfulness of dexterity-related activities.
• Targeted interventions addressing UL function require a thorough understanding of individual dexterity limitations.