Home Based Training for Dexterity in Parkinson's Disease: A Randomized Controlled Trial

Parkinsonism Relat Disord. 2017 Aug;41:92-98. doi: 10.1016/j.parkreldis.2017.05.021. Epub 2017 May 25.

Abstract

Background: Patients with Parkinson's disease exhibit disturbed manual dexterity. This impairment leads to difficulties in activities of daily living, such as buttoning a shirt or hand-writing. The aim of the present study was to investigate the effectiveness of a home-based dexterity program on fine motor skills in a single-blinded, randomized controlled trial, in patients with Parkinson's disease.

Methods: One hundred and three patients with Parkinson's disease (aged between 48 and 80 years, Hoehn & Yahr stage I-IV) were randomized to either a home-based dexterity program (HOMEDEXT) or Thera-band program. All patients trained over a period of 4 weeks, 5 times/week, 30 min for each session. A baseline, post-intervention, and follow-up assessment (12 weeks later, time period without intervention) were done. The primary outcome measure was dexterity as measured with the Nine Hole peg test (9-HPT). Secondary outcome measures included strength, motor parkinsonian symptoms, dexterity-related activities of daily living (ADL) and Health-related Quality of Life (HrQoL).

Results: There was a significant difference in favor of the HOMEDEXT group as compared to the Thera-band group on the primary outcome 9-HPT (p = 0.006) and dexterity-related ADL (p = 0.02) at post intervention. No significant differences were found for the other outcomes, nor at follow-up.

Conclusion: This is the first randomized controlled trial showing that an intensive, task specific home-based dexterity program significantly improved fine motor skills in Parkinson's disease. The effect generalized to dexterity-related ADL functions. As these improvements did not sustain, the finding suggest that continuous training is required to maintain the benefit.

Keywords: Home based training; Manual dexterity; Nine Hole Peg test; Parkinson's disease; Randomized controlled trial.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Aged, 80 and over
  • Analysis of Variance
  • Exercise Therapy / methods*
  • Female
  • Follow-Up Studies
  • Hand / physiology*
  • Humans
  • Male
  • Middle Aged
  • Outcome Assessment, Health Care
  • Parkinson Disease / complications*
  • Parkinson Disease / psychology
  • Parkinson Disease / rehabilitation
  • Psychomotor Disorders / etiology*
  • Psychomotor Disorders / rehabilitation*
  • Quality of Life / psychology
  • Single-Blind Method