Parkinson's disease is associated with impairments in upper extremity function, postural control, and sensory-motor processing that may negatively affect daily activities and quality of life. While upper extremity dysfunction has been extensively investigated, the potential contributions of trunk control and body awareness have received less attention. This cross-sectional observational study aims to compare upper extremity skills, trunk control, and body awareness between individuals with Parkinson's disease and healthy adults, and to examine the relationships among these variables within the Parkinson's disease group. The findings may improve understanding of factors associated with upper extremity performance and support the development of more comprehensive rehabilitation approaches for individuals with Parkinson's disease.
Parkinson's disease (PD) is a progressive neurodegenerative disorder characterized by degeneration of dopaminergic neurons and the presence of both motor and non-motor symptoms. In addition to the cardinal motor features of tremor, rigidity, bradykinesia, and postural instability, individuals with PD commonly experience impairments in upper extremity function that negatively affect daily activities and participation. Difficulties in hand strength, manual dexterity, reaction time, movement speed, and upper limb coordination may interfere with reaching, grasping, object manipulation, and fine motor tasks. Upper extremity performance in PD is influenced by several factors beyond the primary motor symptoms. Trunk control provides proximal stability required for efficient upper limb movement and functional task performance. Deficits in postural control, trunk mobility, and postural alignment may therefore contribute to upper extremity limitations. In addition, body awareness, defined as the perception and interpretation of bodily sensations, movements, and physical changes, has received increasing attention in neurological rehabilitation. Altered sensory integration, impaired kinesthetic processing, and movement-related difficulties observed in PD may affect body awareness and subsequently influence motor performance. Although upper extremity dysfunction has been widely investigated in Parkinson's disease, the combined examination of upper extremity skills, trunk control, and body awareness remains limited. Furthermore, studies investigating body awareness in individuals with PD are scarce, and the relationship between body awareness and upper extremity performance has not been sufficiently explored. The primary aim of this study is to investigate upper extremity skills, trunk control, and body awareness in individuals with Parkinson's disease and compare these characteristics with those of healthy adults. The secondary aim is to examine the relationships among upper extremity performance, trunk control, and body awareness within the Parkinson's disease group. This study is designed as a cross-sectional observational study and does not include any intervention. A total of 118 participants will be recruited, including 59 individuals diagnosed with idiopathic Parkinson's disease and 59 age- and sex-matched healthy adults. Participants with Parkinson's disease will be evaluated during their medication "on" period. All assessments will be completed in a single session. Data collection will include demographic and clinical characteristics, cognitive screening, disease staging, assessment of hand grip and pinch strength, upper extremity reaction time and movement speed, manual dexterity, self-reported upper extremity function, trunk control, and body awareness. Comparisons will be performed between the Parkinson's disease and healthy control groups, and associations among upper extremity skills, trunk control, and body awareness will be analyzed within the Parkinson's disease group. The findings of this study are expected to provide a better understanding of the factors associated with upper extremity performance in Parkinson's disease and to clarify the potential contributions of trunk control and body awareness. Improved knowledge of these relationships may support the development of more comprehensive physiotherapy assessment and rehabilitation strategies for individuals with Parkinson's disease.
Study Type
OBSERVATIONAL
Enrollment
118
Başkent University Hospitals
Ankara, Turkey (Türkiye)
Manual Dexterity Measured by Purdue Pegboard Test
The Purdue Pegboard Test is used to measure gross movements of the hands, fingers and arms, as well as fingertip dexterity. The assessment includes four subtests: preferred hand, non-preferred hand, both hands, and assembly. For the first three subtests, the score is the number of pins placed within a 30 second time limit (higher numbers indicate better dexterity). For the assembly subtest, the score is the number of parts assembled in 60 seconds (higher numbers indicate better dexterity).
Time frame: Baseline
Hand Grip Strength Measured by Hand Dynamometer
Hand grip strength of both dominant and non-dominant hands is measured using a standart digital hand dynamometer. Participants perform maximum isometric contractions in a seated position. Measurement is recorded in kilograms (kg). The average value of three trials is used. Higher scores indicate greater hand grip strength.
Time frame: Baseline
Pinch Strength Measured by Pinch Gauge
Pinch strength is evaluated using a standard mechanical or digital pinch gauge (pinchmeter) to assess lateral (key) pinch strength and palmar (tip-to-tip) pinch strength for both dominant and non-dominant hands. Participants perform maximum isometric contractions. Measurement is recorded in kilograms (kg) or pounds (lbs). Higher scores indicate greater pinch strength.
Time frame: Baseline
Reaction Time Measured by Light Trainer System
Visual and auditory reaction times are assessed using an electronic light trainer system. The system measures the latency between the presentation of a light stimulus and the participant's physical response (hitting or pressing the light target)while tracking the total number of successfully touched targets. The time score is recorded in milliseconds (ms). Lower time scores and higher hit counts indicate faster reaction time and better overall performance.
Time frame: Baseline
Reaction Time Measured by Ruler Drop Test
The ruler drop test is used to evaluate clinical reaction time based on free-fall distance. A standard metric ruler is suspended and dropped without warning, and the participant catches it as quickly as possible. The distance fallen is measured in centimeters (cm) using a standard formula. Lower distances indicate faster reaction time.
Time frame: Baseline
Motor Speed and Coordination Measured by Finger Tapping Test
The Finger Tapping Test is used to assess motor speed, coordination, and bradykinesia in the upper extremities. Participants are asked to tap their index finger against their thumb as rapidly and fully as possible within a specified time frame (typically 60 seconds) or for a set number of repetitions. The score is recorded as the total number of correct taps achieved within the time limit. Higher numbers of taps indicate faster motor speed and better neurological function.
Time frame: Baseline
Trunk Control Measured by Trunk Impairment Scale
The TIS evaluates motor impairment of the trunk through three subscales: static sitting balance, dynamic sitting balance, and coordination. Total scores range from 0 to 23. Higher scores indicate better trunk control and balance.
Time frame: Baseline
Body Awareness Measured by Body Awareness Questionnaire (BAQ)
The BAQ is a self-report scale designed to assess non-clinically invert-focused body awareness, such as sensitivity to normal bodily processes and changes. It consists of 18 items scored on a 7-point Likert scale (1 = not at all true of me, 7 = very true of me). Total scores range from 18 to 126. Higher scores indicate a higher level of subjective body awareness.
Time frame: Baseline
Upper Extremity Disability Measured by Disabilities of the Arm, Shoulder and Hand (DASH) Questionnaire
The DASH questionnaire is a 30-item self-report questionnaire designed to measure physical function and symptoms in patients with musculoskeletal disorders of the upper limb. Items are scored on a 5-point Likert scale. The responses are used to calculate a scale score ranging from 0 (no disability) to 100 (most severe disability). Lower scores indicate better upper extremity function and less disability.
Time frame: Baseline
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