What is a Parkinson’s Hand Test?
Before we discuss what a is, let’s talk about a particular condition that usually comes alongside Parkinson’s Disease: Bradykinesia.
Bradykinesia is a symptom of Parkinson’s Disease, and it is present in almost every patient with it. If a patient has Bradykinesia, they will struggle to start a movement in their upper and/or lower extremities, and once they do start a movement, it is often sluggish. In the context of this particular assessment, the hands, including the wrists and fingers, show slowness of movement.
The Parkinson’s Hand Test is a type of Parkinson’s Test that focuses on the hands. It doesn’t just point to one particular test. It could be any one of these:
- Finger Tapping - The patient will tap their thumb and index finger repeatedly for a set amount of time (which is up to the healthcare professional). They need to do this for both hands.
- Hand Grip - This is also known as the Fist Open-Close Test. It’s self-explanatory. The patient just needs to open and close their fists repeatedly, also for a set amount of time. They also need to perform this for both hands.
- Hand Pronation/Supination - The patient extends their arm forward, and they will repeatedly pronate and supinate their hands for a set amount of time.
For the purpose of this guide, we will discuss all three of these because you want to cover as much ground as possible before diagnosing your patient with Parkinson’s Disease.
How to perform the Parkinson’s Hand Test?
For your benefit, we will show you a template later for the Parkinson’s Hand Test. Instead of doing just one of the aforementioned three, you will be doing all three!
Before conducting any of these tests, prepare two comfortable chairs with backrests. You will have your patient sit down, and you will sit down beside them (with you facing their side to observe their movements). Once you’re both seated, you can begin testing them.
- Finger Tapping Test
During this test, you will simply have your patient tap their thumb and index finger as fast as possible. Before each tap, they need to separate their thumb and index finger as far as possible before tapping them together. They must do this for both hands, but only one at a time.
As for you, you will need to observe how fast they can tap and how wide they can separate their thumbs and index fingers from each other before each tap.
Have them do this for at least ten seconds per hand.
- Hand Grip
Contrary to what this test is called, the patient will not exactly grip anything. They just need to open and close their fists repeatedly. Whenever they open their fists, they must spread their fingers as wide as possible before closing their fist again.
While they open and close their fists, observe how fast they can do it and how wide they can spread their fingers before closing their fists.
Have them do this for at least ten seconds per hand.
- Hand Pronation/Supination
Have your patient flex their shoulder forward by 90 degrees. Next, have them straighten their arm forward. While their arm is straightened, they need to pronate and supinate their hands repeatedly.
While they pronate and supinate their hands, observe how fast they can alternate between the two positions. Plus, check if they can fully pronate and supinate their hands or if they can only do so partially.
Have them do this for at least ten seconds per hand.
These hand tests for Parkinson’s are merely for checking if the patient possibly has Bradykinesia, so it doesn’t give the full picture of the patient’s condition. In fact, these hand tests aren’t the only tests for checking Bradykinesia. Two involve the lower extremities: Heel Tapping and Toe Tapping.
After conducting the hand tests, you should conduct the Heel Tapping and Toe Tapping tests. There are also other things to consider, like rigidity, gait abnormalities, balance abnormalities, and tremors. Please assess the patient for those as well before conducting the likes of DAT Scans and SPECT (Single-Photon Emission Computerized Tomography) Scans.
Parkinson’s Hand Test Example
For your benefit, we created a sheet template for these Parkinson’s Hand Tests that you can use while you conduct them! The sheet contains instructions on performing all three tests (just in case you need a refresher), but more importantly, it has additional comment boxes for all three tests. You can write down your observations in these boxes, like how fast they can perform the exercises, if they can sustain their speed or if they slow down mid-exercise, and if they have a hard time moving their hands.
If you like what you see and believe this sheet is good for your work involving Parkinson’s Disease, then feel free to download it from our platform – it’s free!
You can print it and fill it out with a pen, or go paperless and engage with the additional comment boxes on the PDF since they have editable fields.
When is it best to use this Parkinson’s Hand Test template?
Before you even decide to start using our Parkinson’s Hand Test template, you must first determine if the patient is eligible for Parkinson’s Disease diagnostic tests. In order for them to be eligible, they must exhibit the following symptoms:
- Bradykinesia (the slowness of movement), which is what these hand tests are designed to check
- If they are having trouble balancing, or if they have fallen and are now prone to falling as a result
- If they have tremors in their limbs even while they’re at rest
- If there is rigidity in their arms, legs, and/or trunk
If they have signs of Bradykinesia, that’s the best time to whip out a copy of our Parkinson’s Hand Test template and conduct hand tests for Parkinson’s.
Do remember that the Parkinson’s Hand Tests and our template should always be included as part of a comprehensive examination. These tests should not be the only ones you conduct because they won’t give you the full picture of the patient. Any person can have slowness of movement, especially if they’re old.
After conducting these hand tests, you must conduct other tests to account for the other signs of Parkinson’s Disease so you have better results to work with before conducting scans. The reason for this is that there is a chance that you might misdiagnose your patient with Parkinson’s.
Based on the research conducted by N.P.S. Bajaj et al. (Accuracy of clinical diagnosis in tremulous parkinsonian patients: a blinded video study. J Neurol Neurosurg Psychiatry, 81(11):1223–1228, Nov 2010) and C.B. Levine et al. (Diagnosis and treatment of Parkinson’s disease: a systematic review of the literature. Evid Rep Technol Assess (Summ), (57):1–4, May 2003), the rate of misdiagnosis, even among experienced neurologists, is twenty-five percent. That’s why it’s best to cover all possible bases first.
What are the benefits of the Parkinson’s Hand Test?
These tests are inexpensive and easy to conduct.
None of the three hand tests for Parkinson’s require special equipment. The healthcare professional simply needs to demonstrate the instructions to the patient, and all the patient has to do is perform the instructions for ten seconds per hand. The professional needs to observe how fast the patient can repeat the instructions within ten seconds, and if they have any difficulties performing the exercises.
The difficulty that will arise from these hand tests will be on the side of the patient. If they have Parkinson’s, then they will be slow.
It accounts for people with arthritis.
If, by any chance, your patient has arthritis, then that might hinder them from performing the Finger Tapping Test. Arthritis in their fingers will affect their ability to tap their thumbs and index fingers repeatedly at a fast pace. This will not produce ideal results.
To work around this, you can opt for the Hand Grip and Hand Pronation/Supination Tests. Even if you take the Finger Tapping Test out of the equation, you will still get valuable results concerning Bradykinesia.
These tests can be used to monitor patients down the line.
While Parkinson’s Disease can’t be cured, there are ways to treat it in the sense that the symptoms become manageable that the patient afflicted with the disease can still improve their quality of life despite having it. Treatment can involve medication, physical therapy, and even surgery!
Let’s say you developed and implemented a treatment plan for your patient, which involves medication and physical therapy. Naturally, you’d want to know how they are doing and if the plan is working. You can schedule routine check-ups and conduct hand tests for Parkinson’s to check if they can move their hands, fingers, and wrists faster. You can also conduct other tests for their lower extremities, tremors, etc.
If they are getting better, even if the improvements are small, then it’s safe to say that the patient’s Parkinson’s Disease is slowly becoming manageable and your plan is working. If not, you might want to make some adjustments to your plan and see if the changes will do the trick.
Why use Carepatron for Parkinson’s Disease-related work?
Neurologists are the healthcare professionals that assess patients for the possibility of Parkinson’s Disease. They are well-trained and equipped to do so because they specialize in dealing with nervous system disorders such as the said disease.
If you happen to be a neurologist, or if you’re a healthcare professional working with a neurologist or two but you specialize in something like physical therapy, you’ll definitely have a great time exploring the Carepatron platform!
One of the features that you will come across (and it is one of the features that we’re most proud of) is our resource repository! This massive library of resources houses numerous worksheets, assessments (including our template for the Parkinson’s Hand Tests), survey templates, form templates, progress note templates, and much more! We even have assessments that you can use to evaluate patients with neurological disorders and physical therapy examination sheet templates for patients who will undergo therapy as part of their treatment plan. They’re free, and you can download as much as you want and need!
We also have a nifty storage system that allows you to store your clinical documents with us in a HIPAA-compliant manner! If you downloaded our Parkinson’s Hand Tests template, you can store filled-out versions with us! Even if you’re storing them with us, we can’t access them because only you can decide who can access your files. We recommend that you share it with your team so that you can share results instantly, and they can do the same with their respective tests (if any).
We’re all about helping healthcare professionals with their work, so take advantage of our platform so we can help streamline your workflows and preserve your work!