Validity and Reliability of the Six-Minute Pegboard Ring Test in Individuals With Parkinson's Disease

Validity and Reliability of the Six-Minute Pegboard Ring Test for Assessing Functional Capacity and Upper Extremity Function in Individuals With Parkinson's Disease

Parkinson's patients who volunteer to participate in the study will be included. Parkinson's patients participating in the study will be referred from the SANKO University Hospital Neurology Outpatient Clinic. The assessments of patients referred from the Neurology Outpatient Clinic will be conducted at the SANKO University Physiotherapy and Rehabilitation Department Research Laboratory. The socio-demographic information of the included patients will be collected. Patients will then be grouped using the Hoehn-Yahr Staging Scale. Vital signs such as blood pressure, saturation, and pulse will be measured. Upper extremity muscle strength will be assessed using a dynamometer. Upper extremity performance will be assessed using the Nine-Hole Peg Test. The patient's fatigue will be assessed using the Fatigue Severity Scale, and upper extremity disability will be assessed using the Disability of the Arm, Shoulder, and Hand (DASH) questionnaire. The assessments will be conducted by Physiotherapist Rüveyda GÜRDAL.Except for the six-minute pegboard ring test, the other tests will evaluate the parameters required for an individual's upper extremity function. These parameters are balance, muscle strength, and fine motor skills. The six-minute pegboard ring test will be reassessed one week later by a different physiotherapist at the SANKO University Department of Physiotherapy and Rehabilitation Research Laboratory.

Study Overview

• Status: Completed
• Conditions: Functional Capacity; Parkinson's Disease (PD); Validity and Safety; Upper Extremity Function

Detailed Description

Parkinson's disease (PD) primarily arises from the progressive degeneration of the nigrostriatal dopaminergic pathway and neurons in the substantia nigra pars compacta, which aggregate in the form of Lewy bodies or Lewy neurites. PD is the second most common neurodegenerative disease after Alzheimer's disease, with a prevalence of 0.3% in the general population and 1-3% in the population over 65 years of age. As the disease progresses, the decrease in dopamine levels leads to resting tremor, bradykinesia, rigidity, impaired reflexes, depression, anxiety, emotional changes, cognitive impairment, difficulty swallowing, chewing and speaking, blank facial expressions, urinary problems, constipation, fatigue and sleep problems. Although the course and rate of progression of Parkinson's disease, which has an insidious onset, vary from patient to patient, the symptoms progress over the years in an extremely slow but gradually increasing manner. The asymmetric onset of the disease is very typical, and motor symptoms usually begin with resting tremor. Asymmetry in symptoms is maintained throughout the course of the disease, and bradykinesia develops to varying degrees in each patient. While there is a decrease in movement speed and amplitude (bradykinesia) in the early stages of the disease, it can progress over time and turn into akinesia. Initially, only the distal muscles are affected (micrographia, limited finger movements), but over time, all muscle groups become involved, and patients may eventually become unable to perform activities of daily living. We believe that the six-minute pegboard ring test may be valid and reliable in these individuals. If found to be valid and reliable, its use is recommended for the assessment of individuals diagnosed with Parkinson's disease. Assessments of patients referred from the SANKO University Hospital Neurology Outpatient Clinic will be conducted at the SANKO University Physiotherapy and Rehabilitation Department Research Laboratory. The socio-demographic information of the included patients will be collected. Subsequently, patients will be grouped using the Hoehn-Yahr Staging Scale. Vital signs such as blood pressure, saturation, and pulse will be checked. Upper extremity muscle strength will be assessed using a dynamometer. Upper extremity performance will be assessed using the Nine-Hole Peg Test. The patient's fatigue will be assessed using the Fatigue Severity Scale, and upper extremity disability will be assessed using the Disability of Arm, Shoulder, and Hand Questionnaire (DASH). The assessments will be conducted by Fzt. Rüveyda GÜRDAL. Except for the six-minute pegboard ring test, the other tests will evaluate the parameters required for an individual's upper extremity function. These parameters are balance, muscle strength, and fine motor skills. The six-minute pegboard ring test will be reassessed one week later by a different physiotherapist at the SANKO University Department of Physiotherapy and Rehabilitation Research Laboratory.

• Study Type: Observational
• Enrollment (Actual): 47

Contacts and Locations

Study Locations

• Turkey (Türkiye)
  • Gaziantep, Turkey (Türkiye), 27090
    • Sanko Unıversıty

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

• Sampling Method: Probability Sample

Study Population

Patients diagnosed with Parkinson's disease at the SANKO University Sani Konukoğlu Application and Research Hospital Neurology Outpatient Clinic

Description

Inclusion Criteria:

• Having been diagnosed with Parkinson's disease
• Being over 35 years of age
• Not having changed medications in the last 2 months
• Being able to walk with or without assistance
• Volunteering to participate in the study

Exclusion Criteria:

• Having a neurological disorder other than Parkinson's disease
• Having a visual impairment
• Having dyskinesia severe enough to interfere with the test

Study Plan

How is the study designed?

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Nine-Hole Peg Test	It is a simple, timed test used to assess an individual's fine motor skills, hand-eye coordination, and upper extremity function. The test board has 9 small holes. There are 9 small pegs in front of the person. The participant uses one hand to place the pegs into the holes one by one, then removes them again. This process should be completed in the shortest possible time. It is performed separately for each hand. The time is measured for evaluation.	1 year
Blood Pressure	As our study involves the assessment of functional capacity and upper extremity function, these parameters will be measured during the test, as the individual's physiological state must remain stable	1 year
Manual muscle test device	Muscle strength (right foot dorsi flexion, left foot dorsi flexion, right foot plantar flexion, left foot plantar flexion) will be measured with Commander Echo brand manual muscle test device. The participant will be asked to resist the resistance as much as possible and the maximum force will be recorded. After the participants are informed, 1 trial will be performed. Muscle strength measurement will be repeated 3 times and the average value will be recorded in kilograms.	1 year
Fatigue Severity Scale	On the nine-item scale, the highest score is 63 and the lowest score is 9. An increase in the fatigue severity scale score indicates a higher level of fatigue.	1 year
Wrist, Shoulder, and Hand Problems Survey(DASH)	This is a self-report questionnaire developed to assess functional limitations and pain levels in the arm, shoulder, and hand regions of individuals. It consists of a total of 30 questions. It inquires about the person's daily living activities, symptoms, and functionality over the past week. Subheadings: daily living activities (carrying objects, writing, combing hair, etc.), symptom assessment (pain, stiffness, weakness), social life and psychological impact, work/activity limitations. Each question is rated from 1 (no difficulty) to 5 (great difficulty/unable to perform). Score range: 0-100. 0 points: No limitations. 100 points: Maximum limitations and problems. At least 27 questions must be answered.	1 year
Hoehn and Yahr Staging Scale	It is a 5-level classification system developed in 1967 and used to determine the clinical stage of Parkinson's disease based on motor symptoms. It is frequently used to determine the progression of the disease and support treatment planning. The stages are as follows: Stage 1: Only unilateral symptoms Stage 2: Bilateral symptoms, no balance issues Stage 3: Mild postural imbalance, still independent Stage 4: Significant motor impairment, requires some assistance Stage 5: Wheelchair-bound or bedridden	1 year

Collaborators and Investigators

• Sponsor: Sanko University

Study record dates

Study Major Dates

• Study Start (Actual): November 1, 2025
• Primary Completion (Actual): December 15, 2025
• Study Completion (Actual): February 6, 2026

Study Registration Dates

• First Submitted: February 11, 2026
• First Submitted That Met QC Criteria: February 18, 2026
• First Posted (Actual): February 19, 2026

Study Record Updates

• Last Update Posted (Actual): February 19, 2026
• Last Update Submitted That Met QC Criteria: February 18, 2026
• Last Verified: February 1, 2026

More Information

Terms related to this study

• Keywords: Parkinson's Disease; Functional Capacity; Validity and Reliability; Upper Extremity Function
• Additional Relevant MeSH Terms: Synucleinopathies; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Neurodegenerative Diseases; Movement Disorders; Parkinsonian Disorders; Basal Ganglia Diseases; Parkinson Disease
• Other Study ID Numbers: hakanpolat10

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: UNDECIDED
• IPD Plan Description: will be decided when the study is completed

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No