People with mild Parkinson's disease have impaired force production in upper limb muscles: A cross-sectional study

Renee Salmon, Elisabeth Preston, Niruthikha Mahendran, Louise Ada, Allyson Flynn, Renee Salmon, Elisabeth Preston, Niruthikha Mahendran, Louise Ada, Allyson Flynn

Abstract

Background: There has been little examination of force production of the upper limb in people with Parkinson's disease (PD), despite its impact on activities of daily living and clear evidence that force production is significantly reduced in lower limb muscle groups. The aim of this study was to determine the force production of the major muscle groups of the upper limb in people with PD during the "on" phase after medication, compared with aged-matched neurologically-normal controls.

Method: A cross-sectional study was carried out.

Participants: Thirty people with mild PD (Hoehn Yahr mean 1.1) and 24 age-matched neurologically-normal controls.

Outcome measures: Maximum isometric force production of the shoulder flexors, extensors, abductors, adductors, internal rotators and external rotators, elbow flexors and extensors, wrist flexors and extensors and hand grip using dynamometry.

Results: There was a significant impairment in force production in all upper limb muscle groups, compared with control participants, except in the wrist flexors. On average the deficit in force production was 22%, despite people with PD having mild disease, being physically active and being measured during the "on" phase of medication. The most severely affected muscle groups were the upper limb extensors.

Conclusion: People with PD have a significant deficit in force production of the upper limb muscle groups compared with age-matched neurologically normal controls.

Clinical implications: Regular assessment of strength of the upper limb should be considered by clinicians and strengthening interventions could be implemented if a deficit is identified.

Keywords: Parkinson disease; muscle strength; rehabilitation; upper extremity.

Conflict of interest statement

The authors declare no conflict of interest.

© 2022 The Authors. Physiotherapy Research International published by John Wiley & Sons Ltd.

References

    1. Allen, N. E. , Canning, C. G. , Sherrington, C. , & Fung, V. S. (2009). Bradykinesia, muscle weakness and reduced muscle power in Parkinson's disease. Movement Disorders, 24(9), 1344–1351. 10.1002/mds.22609
    1. Andrews, A. W. , Thomas, M. W. , & Bohannon, R. W. (1996). Normative values for isometric muscle force measurements obtained with hand‐held dynamometers. Physical Therapy, 76(3), 248–259. 10.1093/ptj/76.3.248
    1. Bohannon, R. W. (1986). Test‐retest reliability of hand‐held dynamometry during a single session of strength assessment. Physical Therapy, 66(2), 206–209. 10.1093/ptj/66.2.206
    1. Canning, C. G. , Ada, L. , Johnson, J. J. , & McWhirter, S. (2006). Walking capacity in mild to moderate Parkinson's disease. Archives of Physical Medicine and Rehabilitation, 87(3), 371–375. 10.1016/j.apmr.2005.11.021
    1. Cano‐De‐La‐Cuerda, R. , Pérez‐de‐Heredia, M. , Miangolarra‐Page, J. C. , Muñoz‐Hellín, E. , & Fernandez‐de‐las‐Penas, C. (2010). Is there muscular weakness in Parkinson's disease? American Journal of Physical Medicine & Rehabilitation, 89(1), 70–76. 10.1097/phm.0b013e3181a9ed9b
    1. De Lau, L. M. , & Breteler, M. M. (2006). Epidemiology of Parkinson's disease. The Lancet Neurology, 5(6), 525–535. 10.1016/s1474-4422(06)70471-9
    1. Harris, J. E. , & Eng, J. J. (2007). Paretic upper‐limb strength best explains arm activity in people with stroke. Physical Therapy, 87(1), 88–97. 10.2522/ptj.20060065
    1. Jones, G. R. , Roland, K. P. , Neubauer, N. A. , & Jakobi, J. M. (2017). Handgrip strength related to long‐term electromyography: Application for assessing functional decline in Parkinson disease. Archives of Physical Medicine and Rehabilitation, 98(2), 347–352. 10.1016/j.apmr.2016.09.133
    1. Kakinuma, S. , Nogaki, H. , Pramanik, B. , & Morimatsu, M. (1998). Muscle weakness in Parkinson's disease: Isokinetic study of the lower limbs. European Neurology, 39(4), 218–222. 10.1159/000007937
    1. Kolber, M. J. , & Cleland, J. A. (2005). Strength testing using hand‐held dynamometry. Physical Therapy Reviews, 10(2), 99–112. 10.1179/108331905X55730
    1. Lima, L. O. , Scianni, A. , & Rodrigues‐de‐Paula, F. (2013). Progressive resistance exercise improves strength and physical performance in people with mild to moderate Parkinson's disease: A systematic review. Journal of Physiotherapy, 59(1), 7–13. 10.1016/s1836-9553(13)70141-3
    1. Lundgren‐Lindquist, S. (1983). Functional studies in 79‐year‐olds. II. Upper extremity function. Scandinavian Journal of Rehabilitation Medicine, 15(3), 117–123.
    1. Mercier, C. , & Bourbonnais, D. (2004). Relative shoulder flexor and handgrip strength is related to upper limb function after stroke. Clinical Rehabilitation, 18(2), 215–221. 10.1191/0269215504cr724oa
    1. Moreno Catala, M. , Woitalla, D. , & Arampatzis, A. (2013). Central factors explain muscle weakness in young fallers with Parkinson's disease. Neurorehabilitation and Neural Repair, 27(8), 753–759. 10.1177/1545968313491011
    1. Morris, M. E. (2000). Movement disorders in people with Parkinson disease: A model for physical therapy. Physical Therapy, 80(6), 578–597. 10.1093/ptj/80.6.578
    1. Nogaki, H. , Kakinuma, S. , & Morimatsu, M. (2001). Muscle weakness in Parkinson's disease: A follow‐up study. Parkinsonism & Related Disorders, 8(1), 57–62. 10.1016/S1353-8020(01)00002-5
    1. Pääsuke, M. , Ereline, J. , Gapeyeva, H. , Joost, K. , Mõttus, K. , & Taba, P. (2004). Leg‐extension strength and chair‐rise performance in elderly women with Parkinson's disease. Journal of Aging and Physical Activity, 12(4), 511–524. 10.1123/japa.12.4.511
    1. Pang, M. Y. , & Mak, M. K. (2009). Trunk muscle strength, but not trunk rigidity, is independently associated with bone mineral density of the lumbar spine in patients with Parkinson's disease. Movement Disorders, 24(8), 1176–1182. 10.1002/mds.22531
    1. Pedersen, S. W. , Bäckman, E. , & Oberg, B. (1991). Characteristics of tetanic muscle contraction in Parkinson patients. Acta Neurologica Scandinavica, 84(3), 250–255. 10.1111/j.1600-0404.1991.tb04946.x
    1. Pink, B. , Jette, N. , Frolkis, A. , & Steeves, T. D. (2013). Socio‐economic indexes for areas (SEIFA). Canberra.
    1. Pringsheim, J. , & Frolkis, S. (2014). The prevalence of Parkinson's disease: A systematic review and meta‐analysis. Movement Disorders, 29(13), 1583–1590. 10.1002/mds.25945
    1. Robichaud, J. A. , Pfann, K. D. , Comella, C. L. , Brandabur, M. , & Corcos, D. M. (2004). Greater impairment of extension movements as compared to flexion movements in Parkinson's disease. Experimental Brain Research, 156(2), 240–254. 10.1007/s00221-003-1782-0
    1. Roeder, L. , Costello, J. T. , Smith, S. S. , Stewart, I. B. , & Kerr, G. K. (2015). Effects of resistance training on measures of muscular strength in people with Parkinson's disease: A systematic review and meta‐analysis. PLoS One, 10(7), e0132135. 10.1371/journal.pone.0132135
    1. Roland, K. P. , Jones, G. R. , & Jakobi, J. M. (2013). Parkinson's disease and sex‐related differences in electromyography during daily life. J Electromyogr Kines, 23(4), 958–965. 10.1016/j.jelekin.2013.03.008
    1. Rossi, B. , Siciliano, G. , Carboncini, M. C. , Manca, M. L. , Massetani, R. , Viacava, P. , & Muratorio, A. (1996). Muscle modifications in Parkinson's disease: Myoelectric manifestations. Electroencephalography and Clinical Neurophysiology, 101(3), 211–218. 10.1016/0924-980X(96)94672-X
    1. Salmon, S. , Preston, E. , Mahendran, N. , Flynn, A. , & Ada, L. (2021). People with mild PD have impaired force production in all lower limb muscle groups: A cross‐sectional study. Physiotherapy Research International, 26(2), e1897. 10.1002/pri.1897
    1. Skinner, J. W. , Christou, E. A. , & Hass, C. J. (2019). Lower extremity muscle strength and force variability in persons with Parkinson disease. Journal of Neurologic Physical Therapy, 43(1), 56–62. 10.1097/npt.0000000000000244
    1. Turrell, G. , & Mathers, C. D. (2000). Socioeconomic status and health in Australia. Medical Journal of Australia, 172(9), 434–438. 10.5694/j.1326-5377.2000.tb124041.x
    1. Tyson, S. F. , Chillala, J. , Hanley, M. , Selley, A. B. , & Tallis, R. C. (2006). Distribution of weakness in the upper and lower limbs post‐stroke. Disability & Rehabilitation, 28(11), 715–719. 10.1080/09638280500301584
    1. van Nimwegen, M. L. , Speelman, A. D. , Hofman‐van Rossum, E. J. , Overeem, S. , Deeg, D. J. G. , Borm, G. F. , Horst, M. H. L. , Bloem, B. R. , & Munneke, M. (2011). Physical inactivity in Parkinson's disease. Journal of Neurology, 258(12), 2214–2221. 10.1007/s00415-011-6097-7
    1. Yanagawa, S. , Shindo, M. , & Yanagisawa, N. (1990). Muscular weakness in Parkinson's disease. Advances in Neurology, 53, 259–269.

Source: PubMed

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