Abstract
Introduction: Parkinson’s disease (PD) leads to deficits in upper limb strength and manual dexterity and consequently resulting in functional impairment. Handgrip strength is correlated with the motor symptom severity of the disease, but there is a gap in the literature about the influence of freezing in PD patients. Objective: The objective is to study the correlation between handgrip strength and motor symptom severity considering the freezing phenomenon and to verify variables that can predict Unified Parkinson’s Disease Rating Scale (UPDRS) III. Methods: This is a multicenter cross-sectional study in PD. 101 patients were divided into 2 groups: freezing of gait (FOG) (n = 51) and nonfreezing (nFOG) (n = 52). Freezing of Gait Questionnaire (FOGQ); UPDRS II and III sections; Hoehn and Yahr (HY) scale; handgrip dynamometry (HD); 9 Hole Peg Test (9-HPT) were assessed. Results: In both groups, HD was correlated to UPDRS III (nFOG: −0.308; FOG: −0.301), UPDRS total (nFOG: −0.379; FOG: −0.368), UPDRS item 23 (nFOG: −0.404; FOG: −0.605), and UPDRS item 24 (nFOG: −0.405; FOG: −0.515). For the correlation to UPDRS II (0.320) and 9-HPT (−0.323), only nFOG group presented significance. For the UPDRS 25 (−0.437), only FOG group presented statistical significance. The UPDRS III can be predicted by 9-HPT, age, and HY in nFOG patients (Adjusted R2 = 0.416). In FOG group, UPDRS III can be predicted by HD, 9-HPT, age, and HY (Adjusted R2 = 0.491). Conclusion: Handgrip strength showed to be predictive of motor impairment only in the FOG group. Our results showed clinical profile differences of motor symptoms considering freezers and nonfreezers with PD.
References
1.
Friedman
JH
, Abrantes
AM
. Self perceived weakness in Parkinson’s disease
. Parkinsonism Relat Disord
. 2012 Aug
;18
(7
):887
–9
. .2.
Cano-de-la-Cuerda
R
, Pérez-de-Heredia
M
, Miangolarra-Page
JC
, Muñoz-Hellín
E
, Fernández-de-Las-Peñas
C
. Is there muscular weakness in Parkinson’s disease?
Am J Phys Med Rehabil
. 2010 Jan
;89
(1
):70
–6
. .3.
Hwang
S
, Song
CS
. Relationship between manual dexterity and the unified parkinson’s disease rating scale-motor exam
. J Phys Ther Sci
. 2016
;28
(12
):3403
–6
. .4.
Corcos
DM
, Chen
CM
, Quinn
NP
, McAuley
J
, Rothwell
JC
. Strength in Parkinson’s disease: relationship to rate of force generation and clinical status
. Ann Neurol
. 1996
;39
(1
):79
–88
. .5.
Fellows
SJ
, Noth
J
. Grip force abnormalities in de novo Parkinson’s disease
. Mov Disord
. 2004
;19
(5
):560
–5
. .6.
Prodoehl
J
, Corcos
DM
, Vaillancourt
DE
. Basal ganglia mechanisms underlying precision grip force control
. Neurosci Biobehav Rev
. 2009
;33
(6
):900
–8
. .7.
Vaillancourt
DE
, Mayka
MA
, Thulborn
KR
, Corcos
DM
. Subthalamic nucleus and internal globus pallidus scale with the rate of change of force production in humans
. Neuroimage
. 2004
;23
(1
):175
–86
. .8.
Pradhan
S
, Scherer
R
, Matsuoka
Y
, Kelly
VE
. Grip force modulation characteristics as a marker for clinical disease progression in individuals with Parkinson disease: case-control study
. Phys Ther
. 2015
;95
(3
):369
–79
. .9.
Giladi
N
, Tal
J
, Azulay
T
, Rascol
O
, Brooks
DJ
, Melamed
E
, et al Validation of the freezing of gait questionnaire in patients with Parkinson’s disease
. Mov Disord
. 2009 Apr
;24
(5
):655
–61
. .10.
Nieuwboer
A
, Vercruysse
S
, Feys
P
, Levin
O
, Spildooren
J
, Swinnen
S
. Upper limb movement interruptions are correlated to freezing of gait in Parkinson’s disease
. Eur J Neurosci
. 2009 Apr
;29
(7
):1422
–30
. .11.
Heremans
E
, Nieuwboer
A
, Vercruysse
S
. Freezing of gait in Parkinson’s disease: where are we now?
Curr Neurol Neurosci Rep
. 2013
;13
(6
):350
. Available from: http://link.springer.com/10.1007/s11910-013-0350-7
.12.
Heremans
E
, Nackaerts
E
, Vervoort
G
, Vercruysse
S
, Broeder
S
, Strouwen
C
, et al Amplitude manipulation evokes upper limb freezing during handwriting in patients with Parkinson’s disease with freezing of gait
. PLoS One
. 2015
;10
(11
):e0142874
. .13.
Vercruysse
S
, Devos
H
, Munks
L
, Spildooren
J
, Vandenbossche
J
, Vandenberghe
W
, et al Explaining freezing of gait in Parkinson’s disease: motor and cognitive determinants
. Mov Disord
. 2012 Nov
;27
(13
):1644
–51
. Available from: .14.
Baggio
JA
, Curtarelli
MB
, Rodrigues
GR
, Tumas
V
. Validity of the Brazilian version of the freezing of gait questionnaire
. Arq Neuropsiquiatr
. 2012 Aug
;70
(8
):599
–603
. .15.
Movement Disorder Society Task Force on Rating Scales for Parkinson’s Disease
. The unified Parkinson’s disease rating scale (UPDRS): status and recommendations
. Mov Disord
. 2003 Jul
;18
(7
):738
–50
. Available from: .16.
Hoehn
MM
, Yahr
MD
. Parkinsonism: onset, progression and mortality
. Neurology
. 1967 May
;17
(5
):427
–42
. .17.
Goetz
CG
, Poewe
W
, Rascol
O
, Sampaio
C
, Stebbins
GT
, Counsell
C
, et al Movement Disorder Society Task Force report on the Hoehn and Yahr staging scale: status and recommendations
. Mov Disord
. 2004 Sep
;19
(9
):1020
–8
. .18.
Nieuwboer
A
, Giladi
N
. Characterizing freezing of gait in Parkinson’s disease: models of an episodic phenomenon
. Mov Disord
. 2013 Sep
;28
(11
):1509
–19
. Available from: .19.
Villafañe
JH
, Valdes
K
, Buraschi
R
, Martinelli
M
, Bissolotti
L
, Negrini
S
. Reliability of the handgrip strength test in elderly subjects with Parkinson disease
. Hand
. 2016
;11
(1
):54
–8
. .20.
Earhart
GM
, Cavanaugh
JT
, Ellis
T
, Ford
MP
, Foreman
KB
, Dibble
L
. The 9-hole peg test of upper extremity function: average values, test-retest reliability, and factors contributing to performance in people with parkinson disease
. J Neurol Phys Ther
. 2011
;35
(4
):157
–63
. .21.
Gill
DJ
, Freshman
A
, Blender
JA
, Ravina
B
. The montreal cognitive assessment as a screening tool for cognitive impairment in Parkinson’s disease
. Mov Disord
. 2008 May
;23
(7
):1043
–6
. Available from: .22.
Dalrymple-Alford
JC
, MacAskill
MR
, Nakas
CT
, Livingston
L
, Graham
C
, Crucian
GP
, et al The MoCA: well-suited screen for cognitive impairment in Parkinson disease
. Neurology
. 2010 Nov
;75
(19
):1717
–25
. .23.
Mukaka
MM
. Statistics corner: a guide to appropriate use of correlation coefficient in medical research
. Malawi Med J
. 2012 Sep
;24
(3
):69
–71
. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/pmc3576830/
.24.
Nowak
DA
, Hermsdörfer
J
. Coordination of grip and load forces during vertical point-to-point movements with a grasped object in Parkinson’s disease
. Behav Neurosci
. 2002
;116
(5
):837
–50
. Available from: http://pesquisa.bvsalud.org/portal/resource/pt/mdl-12369804
.25.
Roberts
HC
, Syddall
HE
, Butchart
JW
, Stack
EL
, Cooper
C
, Sayer
AA
. The association of grip strength with severity and duration of Parkinson’s: a Cross-Sectional Study
. Neurorehabil Neural Repair
. 2015
;29
(9
):889
–96
. Available from:
.26.
Fietzek
UM
, Zwosta
J
, Schroeteler
FE
, Ziegler
K
, Ceballos-Baumann
AO
. Levodopa changes the severity of freezing in Parkinson’s disease
. Parkinsonism Relat Disord
. 2013 Oct
;19
(10
):894
–6
. .27.
Delval
A
, Rambour
M
, Tard
C
, Dujardin
K
, Devos
D
, Bleuse
S
, et al Freezing/festination during motor tasks in early-stage Parkinson’s disease: a prospective study
. Mov Disord
. 2016 Dec
;31
(12
):1837
–45
. Available from: .28.
de Freitas
PR
, Lemos
AE
, Santos
MP
, Michaelsen
SM
, Corrêa
CL
, Swarowsky
A
. “Test D’évaluation Des Membres Supérieurs Des Personnes Âgées” (TEMPA) to assess upper limb activity in Parkinson’s disease
. J Hand Ther
. 2017
;30
(3
):320
–7
. Available from: .29.
Scholten
M
, Govindan
RB
, Braun
C
, Bloem
BR
, Plewnia
C
, Krüger
R
, et al Cortical correlates of susceptibility to upper limb freezing in Parkinson’s disease
. Clin Neurophysiol
. 2016 Jun
;127
(6
):2386
–93
. .30.
Vercruysse
S
, Spildooren
J
, Heremans
E
, Wenderoth
N
, Swinnen
SP
, Vandenberghe
W
, et al The neural correlates of upper limb motor blocks in Parkinson’s disease and their relation to freezing of gait
. Cereb Cortex
. 2014 Dec
;24
(12
):3154
–66
. .31.
Shine
JM
, Matar
E
, Ward
PB
, Bolitho
SJ
, Gilat
M
, Pearson
M
, et al Exploring the cortical and subcortical functional magnetic resonance imaging changes associated with freezing in Parkinson’s disease
. Brain
. 2013 Apr
;136
(Pt 4
):1204
–15
. .32.
Nutt
JG
, Bloem
BR
, Giladi
N
, Hallett
M
, Horak
FB
, Nieuwboer
A
. Freezing of gait: moving forward on a mysterious clinical phenomenon
. Lancet Neurol
. 2011 Aug
;10
(8
):734
–44
. .© 2021 S. Karger AG, Basel
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