A frequency and correlation analysis of motor deficits in Parkinson patients

The present study explored the frequency and pattern of functional motor problems of a group of Parkinson patients, as a first step towards developing a rational approach to rehabilitation intervention addressing the primary symptoms of the disease.

Sixty patients, consisting of 40% women and 60% men with a mean age of 63.5 years and of which 88% were taking L-dopa, underwent a number of standardized clinical tests including part III of the UPDRS. They were also interviewed about the frequency of motor problems occurring at home.

Loss of trunk rotation as expressed in rolling in supine and reduced arm swing were the most frequently registered motor disorders (73%, 75%). Freezing at the start of, or during, walking was not observed during clinical testing but was frequently claimed to occur at home (48%, 23%). A broad spectrum of deficits regarding gait, posture, transfers and distal motor problems formed a cluster, which was strongly correlated with bradykinesia (p < 0.001). Principal component analysis identified four distinct problem areas: (1) axial motor performance; (2) akinetic gait problems; (3) rigidity; and (4) tremor.

Parkinson patients, particularly in the later stages of the disease, presented with significant levels of functional disability which was mainly linked with the underlying impairment of bradykinesia.