The Functional Dexterity Test (FDT) is a standardized assessment used to quantify dexterity, in-hand manipulation, related to function. Recommendations to modify the scoring have been proposed to ...eliminate penalties, adapt the test protocol, and change the outcome parameter. A new psychometrically sound scoring system has been used in the pediatric population; however, research in the adult population requires exploration.
The purpose of this study was to test if alterations in test administration, outcome recording, and outcome parameters show predictive validity for measured outcomes for age, ethnicity, and self-identified gender. The new method of administering the FDT eliminates penalties for improper performance and uses a score of speed derived from the timed score. It was theorized that eliminating assessment of reported errors in quality of movement in the quantitative scoring may improve the test validity.
Clinical Measurement.
The FDT was administered to 148 healthy adults aged between 18 and 78 years. No penalties were included in the quantitative scoring. Age, self-identified gender, ethnicity, and self-reported hand dominance were recorded. Time to complete the test was measured in seconds per usual protocol. The result was recorded as time and calculated as speed. Linear regression was performed to predict FDT speed from age, hand dominance, and self-identified gender.
The three predictors (age, hand dominance, and gender) associated with a linear decline in dexterity were significant (p ≤0.02). Dexterity showed a linear decline with age, and participants showed faster speeds with the dominant hand. Gender was a significant predictor of speed, with males having faster speeds by an average of 0.047 pegs per second (p = 0.01).
Scores using a simplified administration and speed as an outcome showed moderate predictive validity with age, gender, and the dominant hand used in this adult population. Future research exploring relationships with activities of daily living is needed.
•Assessing dexterity in adults using the FDT can be done without scoring penalties.•Similar FDT administration to youth and adults streamlines use for clinicians.•Future research could establish new normative data with the revised procedure.
Clinical measurement.
Many daily living tasks require in-hand manipulation (IHM). There is a gap in standardized assessment tools for measuring IHM. The Corbett Targeted Coin Test (CTCT) was designed ...to allow measurement of that fine motor skill.
1) To evaluate the interrater, test-retest reliability, and validity of the CTCT, and 2) to establish adult norms for the CTCT.
Reliability and Validity – 30 participants (25 females, age range 21–45) were assessed with the Nine-Hole Peg test and CTCT consecutively by three researchers, then re-evaluated one week later on the CTCT; Reliability was determined using intraclass correlation (ICC2,k) between tests and across testers; Criterion-related validity was determined by comparing scores from nine-hole test and CTCT across testers using ICC2,k. Normative – 190 participants (147 females, age range 20–80) were assessed with the CTCT; mean and standard deviation for participants’ scores were calculated by age groups and gender.
Test-retest reliability: poor for the right hand (ICCs = −0.29 to 0.45), and poor-moderate for the left hand (ICCs = 0.17–0.56). Inter-rater reliability ranged from moderate to excellent (ICCs = 0.60–0.80). The agreement between CTCT scores and Nine-Hole Peg test was poor for the right (ICC = 0.02; 95% CI: −0.06, 0.14) and left hands (ICC = 0.06; 95% CI: −0.08, 0.28). CTCT normative data: 41–50 age group demonstrated the highest performance while the 71–80 age group demonstrated the lowest performance. Scores between genders were similar.
The poor test-retest reliability of CTCT was probably due to practice effect, while interrater reliability indicated that the test can be administered by different testers without compromising the results. The poor validity between tools proves their different constructs.
Use of the CTCT may add another dimension to assessment of dexterity and fine motor skills, specifically, in-hand manipulation, but needs further research on test-retest reliability.
•Dexterity assessment.•In-hand manipulation.•Hand function.•Fine motor assessment.
Introduction: Individuals with Parkinson’s Disease commonly experience both physical and psychological effects, which subsequently affect their ability to perform daily activities and overall ...wellbeing. MusicGlove is an emerging adjunct proposed to address the motor issues but also the psychological ones with references to improving motivation and participation in individuals with Parkinson’s Disease. Aim: To determine the effectiveness of the MusicGlove on hand dexterity and the psychological response in individuals with Parkinson’s disease. Materials and Methods: A quasi-experimental study was performed on 40 individuals with Parkinson disease January 2021 to June 2021 from local community settings in Chengalpattu district, Tamil Nadu, India. They were recruited and divided into a control group (n=20) and experimental group (n=20). Hand dexterity and psychological responses were assessed using the Box and Block Test (BBT), Beck’s Depression Inventory (BDI), and Apathy Inventory (AI) as pre and post-test measures. Both groups received conventional occupational therapy for three weeks in total, and in addition to this, the experimental group received the MusicGlove. The control group included muscle stretching and strengthening activities with therapeutic putty and using activities such as connecting circles where the subject is given a sheet of paper with 25 circles, each containing 25 numbers or letters. They were asked to connect these in ascending, alternating numerical, and alphabetical order. Sessions were conducted for 30 minutes with two sets of repetitions. Descriptive statistics were used to examine data using the Statistical Package for Social Sciences (SPSS) version 24.0. Results: The study results revealed that there was no statistically significant difference found between the groups but clinically significant differences were found between the groups with posttest scores on motor symptoms that were measured by BBT: μ=- 1.2534, p=0.211 (BBT Dominant); μ=-0.9400, p-value=0.3472 (BBT Non Dominant), and psychological symptoms that were measured by BDI; (μ=-1.0445, p-value=0.2983) and AI; (μ=- 1.0445, p-value=0.9203). Conclusion: The study concluded that conventional occupational therapy along with MusicGlove was effective in improving hand dexterity and psychological responses in Parkinson’s disease patients. Also, further study needs to be conducted to warrant its long-term impact of intervention on hand dexterity and psychological responses.
To analyse the effectiveness of virtual reality-based interventions within several fields of rehabilitation, and to investigate whether the outcomes of virtual reality-based interventions, in terms ...of upper or lower limb function, gait and balance, differ with respect to the virtual reality system used.
A search of PubMed database resulted in an initial total of 481 records. Of these, 27 articles were included in the study. A final total of 20 articles, with neurological, orthoapedic, geriatric or paediatric patients, published between 2012 and 2019, were included in the study. Two independent reviewers selected potentially relevant articles based on the inclusion criteria for full-text reading. They extracted data, and evaluated the methodological quality of each study.
Seventeen studies were included in the meta¬ -analysis. Eight studies analysed upper limb function, with no significant evidence that specialized VR is superior to conventional treatment. Regarding FuglMeyer scale results, the effect of specialized virtual reality therapy was found to be significantly better than conventional treatment. No significant differences between specialized VR and conventional treatment were observed in effects on hand dexterity and gait. There was a significant difference in effects on balance in favour of specialized virtual reality as compared to conventional treatment. Gaming virtual reality was significantly better than conventional treatment for upper limb function, but not for hand dexterity, gait and balance.
Use of specialized virtual reality and gaming virtual reality can be advantageous for treatment of the upper extremity, but not for hand dexterity and gait in all pathologies considered. Specialized virtual reality can improve balance in neurological patients.
Parkinson's disease (PD) presents with a progressive decline in manual dexterity, attributed to dysfunction in the basal ganglia-thalamus-cortex loop, influenced by dopaminergic deficits in the ...striatum. Recent research suggests that the motor cortex may play a pivotal role in mediating the relationship between striatal dopamine depletion and motor function in PD. Understanding this connection is crucial for comprehending the origins of manual dexterity impairments in PD. Therefore, our study aimed to explore how motor cortex activation mediates the association between striatal dopamine depletion and manual dexterity in PD.
We enrolled 26 mildly affected PD patients in their off-medication phase to undergo 18FFDOPA PET/CT scans for evaluating striatal dopaminergic function. EEG recordings were conducted during bimanual anti-phase finger tapping tasks to evaluate motor cortex activity, specifically focusing on Event-Related Desynchronization in the beta band. Manual dexterity was assessed using the Purdue Pegboard Test. Regression-based mediation analysis was conducted to examine whether motor cortex activation mediates the association between striatal dopamine depletion and manual dexterity in PD.
Mediation analysis revealed a significant direct effect of putamen dopamine depletion on manual dexterity for the affected hand and assembly tasks (performed with two hands), with motor cortex activity mediating this association. In contrast, while caudate nucleus dopamine depletion showed a significant direct effect on manual dexterity, motor cortex mediation on this association was not observed.
Our study confirms the association between striatum dopamine depletion and impaired manual dexterity in PD, with motor cortex activity mediating this relationship.
•Striatum dopamine depletion is associated with manual dexterity.•Motor cortex activity links striatal dopamine depletion to manual dexterity, especially with putamen impairment.•In contrast, the relationship between caudate and manual dexterity is not mediated by motor cortex.
Objective:
The aim of this study was to evaluate the short- and long-term effects as well as other parameters of repetitive transcranial magnetic stimulation (rTMS) on upper limb motor functional ...recovery after stroke.
Data sources:
The databases of PubMed, Medline, Science Direct, Cochrane, and Embase were searched for randomized controlled studies reporting effects of rTMS on upper limb motor recovery published before October 30, 2016.
Review methods:
The short- and long-term mean effect sizes as well as the effect size of rTMS frequency of pulse, post-stroke onset, and theta burst stimulation patterns were summarized by calculating the standardized mean difference (SMD) and the 95% confidence interval using fixed/random effect models as appropriate.
Results:
Thirty-four studies with 904 participants were included in this systematic review. Pooled estimates show that rTMS significantly improved short-term (SMD, 0.43; P < 0.001) and long-term (SMD, 0.49; P < 0.001) manual dexterity. More pronounced effects were found for rTMS administered in the acute phase of stroke (SMD, 0.69), subcortical stroke (SMD, 0.66), 5-session rTMS treatment (SMD, 0.67) and intermittent theta burst stimulation (SMD, 0.60). Only three studies reported mild adverse events such as headache and increased anxiety .
Conclusions:
Five-session rTMS treatment could best improve stroke-induced upper limb dyskinesia acutely and in a long-lasting manner. Intermittent theta burst stimulation is more beneficial than continuous theta burst stimulation. rTMS applied in the acute phase of stroke is more effective than rTMS applied in the chronic phase. Subcortical lesion benefit more from rTMS than other lesion site.
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