June, 2023

Parisa Alaei, MSc. Healthy Exercise and Aging Lab, School of Health and Exercise Sciences, University of British Columbia

Okanagan, Kelowna, BC, Canada

Take home message

  • The Grooved Pegboard Test (GPT) is an effective tool for the assessment of fine motor skills in people with Parkinson’s disease (PD).
  • GPT scores are related to motor symptom severity and time from diagnosis.
  • In the dominant hand, GPT scores are also associated with age.

Background

  • Impaired finger and hand dexterity are common symptoms for persons with PD that impact functional ability, even when they are using dopaminergic medication.
  • A previous study suggested a relation between the severity of motor symptoms in the initial stages of Parkinson’s disease and GPT scores.

How the study was done

  • Eighty-two people (33 females) with PD (50-83 years) were recruited during the dopaminergic “ON” state when the dopamine level is high.
  • The Hoehn and Yahr scale and Montreal cognitive assessment were used to characterize PD progression and cognitive function, respectively.
  • The Unified Parkinson’s Disease Rating Scale (UPDRS) Section III (Motor Examination) and GPT times were used to evaluate finger and hand dexterity.
  • GPT involves inserting key-like pegs one at a time into a 5×5 grid with 25 holes. The task is performed from left to right and row by row with the right hand. For the left hand, the task is completed in the opposite direction.

What the researchers found

  • Time from diagnosis was between 1-180 months and motor symptom severity ranged between 6-56 on the UPDRS-III. Scoring on the UPDRS-III can range between 0–132 with <32 considered mild, 32-59 representing moderate, and >59 being severe.
  • GPT times for each hand were positively related to motor symptom severity and time from diagnosis.
  • Age was associated with the GPT times of the dominant hand but not the non-dominant hand.
  • Motor symptom severity was related to hand and finger dexterity measured by the UPDRS-III.
  • The worsening of finger dexterity was associated with disease progression.

Conclusion

  • The GPT has the potential to monitor a loss of fine motor skills and the progression of fine motor symptoms in those with PD.
  • Clinical exercise physiologists can utilize the GPT to evaluate PD patients’ motor symptom severity for personalized exercise prescriptions.

References

Buard I, Yang X, Kaizer A, Lattanzio L, Kluger B, Enoka RM. Finger dexterity measured by the Grooved Pegboard test indexes Parkinson’s motor severity in a tremor-independent manner. J Electromyogr Kinesiol. 2022 Oct; 66:102695.