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Published on: June 3, 2009
An Alternative Approach to the Finger-Tapping Test in Parkinsonian Patients: Finger to Crease Instead of Finger to
Fahimeh H Akhoundi1, Yvette Bordelon2, James Leverenz3,4,5
1Parkinson and Other Movement Disorders Center, Department of Neurosciences, University of California San Diego, San Diego, California, USA.
Background:
Neurologic examination is still the main source of data gathering for diagnosing and monitoring diseases. Items of neurologic examination need to be researched to assess their reliability, reproducibility, and correlation with various scales.
Objective:
To evaluate the competence of finger to crease (F-C) variation of the finger tapping test as opposed to the traditional method (F-T) in detecting bradykinesia in Parkinson's disease patients and to evaluate the interrater reliability of the test.
Methods:
We compared the two finger tapping variations in 42 Parkinson's disease patients. We examined our patients using the bradykinesia subscale of the Unified Parkinson's Disease Rating Scale (UPDRS) and the Hoehn and Yahr (H&Y) scales with the two methods of the finger-tapping test. To assess the interrater reliability of the test, a different pool of patients was used, in which four movement disorder specialists evaluated videos of 29 patients performing the finger-tapping test using the two methods with each hand.
Results:
Both methods were positively correlated with Parkinson staging based on the H&Y scale and the bradykinesia subsection of the UPDRS. Mean H&Y scores and UPDRS bradykinesia subscale scores given to the patients using the F-C method were significantly higher than those when the F-T method was employed. Using F-C instead of F-T led to a higher H&Y stage placement in 12 subjects. Both methods showed good to excellent inter-rater reliability (Cronbach's alpha >0.80).
Conclusion:
Our findings show that this finger-tapping variation is reliable and may increase the sensitivity of the examination.
