Study: Hand-Grip Test Effectively Assesses Parkinson Decline

In a study designed to determine which clinical measures of physical function best represent long-term electromyography in individuals with Parkinson disease, researchers have found that a hand-grip test is a reliable means of indicating decline in the physical function of these patients.

Led by researchers from the University of British Columbia, the investigators evaluated a sample of 37 men and women; 23 of whom have Parkinson disease and 14 who did not, who live independently at home and are older than 50 years of age.
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Each participant wore a portable monitoring device to measure muscle activity, with the device recording electrical activity of muscles in the arms and legs. Measures of gait, balance, and grip strength were completed, with the authors examining electromyography in biceps brachi, triceps brachi, vastus laterals, and biceps femoris during a 6.5-hour day. Muscle activity was quantified through burst in electromyography, according to the authors, who used stepwise multiple regression models to determine the proportion of variance in burst characteristics explained by clinical measures of physical function.

The researchers found grip strength to be the best predictor of muscle activity in participants with Parkinson disease. Among those in the healthy control group, however, gait characteristics explained muscle activity, according to the authors.

“Primary care practitioners should not only focus their attention on the disease, but should also focus their attention to the physiological capacity (functional reserve) of the patient,” said lead study author Gareth Jones, MSc, PhD, CSEP-CEP, a professor in the School of Health and Exercise Sciences at British Columbia University.

“A simple measure such as grip strength was able to predict subtle changes in the electrical activity of skeletal muscle,” said Jones, adding that “our earlier research demonstrated that EMG recordings of upper and lower body muscle can detect the onset of functional change.”

In a clinical setting, however, these measures are too time consuming and labor intensive, he said. “Thus, we used typical functional assessments of gait, balance, and handgrip and compared these results to the EMG measures. In persons with Parkinson disease (PD), it was grip strength that best predicted the onset of functional change, similar to what the time- and equipment-intensive EMG records revealed.”

Primary care practitioners could use regular assessments of grip strength with their Parkinson patients, just as they would with blood pressure, to assess onset of functional decline,” said Jones.

“It is usually the insidious loss of functional capacity that is responsible for mortality in Parkinson disease, rather than the actual disease,” he concluded. “Therefore, medical practitioners should attend to both management of the neurological disease and the decline of physical capacity that often has a catastrophic consequence for the older adult.”

—Mark McGraw

Reference

Jones G, Roland K, Neubauer NA, Jakobi JM. Handgrip strength related to long-term electromyography: application for assessing functional decline in Parkinson disease. Archives of Physical Medicine and Rehabilitation. 2017.