What is the Parkinson’s Rigidity Test?
Before we discuss what the Parkinson’s Rigidity Test is all about, let’s briefly discuss what rigidity is in the context of Parkinson’s Disease.
Rigidity is one of the main symptoms of Parkinson’s Disease. Most people who have this disease will develop rigidity at some point as their condition develops and progresses.
When we speak of rigidity in this context, we mean the resistance to passive movement in a patient’s joints. Rigidity can also refer to joints and limbs becoming stiff or tight, resulting in a decreased range of motion. An example would be the arm swinging less while walking. Even trunk movements can be impacted by this.
The rigidity can also cause aches in the arms and legs, especially in the muscles. This may affect sleep and make the patient feel uncharacteristically tired.
There are two types of rigidity: Lead Pipe Rigidity and Cogwheel Rigidity. The former is characterized by a constant resistance throughout an entire range of motion, while the latter is characterized by a resistance that starts and stops every now and then while a limb or joint is being moved throughout its range of motion.
To gauge a patient’s rigidity, a healthcare professional will conduct the Parkinson’s Rigidity Test, which is an examination that involves the passive manipulation of a patient’s limbs and joints.
How to conduct the Parkinson’s Rigidity Test
Before you conduct the Parkinson’s Rigidity Test, you must prepare two comfortable chairs. Make sure these chairs have backrests so your patient can relax (and so they don’t fall backward by accident). The patient will be seated throughout this entire test, and you will be seated beside or in front of them because you will be applying passive movement to their limbs. Once you’re both seated, you can begin the test:
- Upper Extremity Rigidity Test
- Tell your patient to relax their arms for the entire part of this test.
- Once they are relaxed, start with the wrist. Place your proximal hand under your patient’s forearm, then use your distal hand to grab the patient’s wrist.
- Passively rotate the wrist until you feel resistance to the rotation. Keep rotating it so you know what type of rigidity the wrist has.
- Next up is the elbow. For this one, you just need to keep passively flexing and extending your patient’s forearm. While flexing and extending the forearm, try to feel for resistance in the movement.
- Do this for both arms to cover all bases.
- Note down your findings.
- Lower Extremity Rigidity Test
- Tell your patient to relax their legs for the entire part of this test.
- Place one of your hands under the patient’s knee to support the leg’s weight. By having your hand support the patient’s knee from right under, the leg should feel relaxed.
- Use your other hand to grab your patient’s foot.
- Rotate the ankle and feel for any resistance in the movement.
- After checking the ankle, passively flex and extend the knee and feel for any resistance while doing so.
- Do this for both legs.
- Note down your findings.
If you’re having trouble getting the limbs to exhibit resistance, you can have your patient tap their hand on their knee repeatedly. The hand and knee should be on the opposite side of the one you’re currently testing. This method is a way to activate any resistance brought about by rigidity.
Once you’re done noting down findings, the next step is to conduct other Parkinson’s Disease-related assessments, specifically ones that check Bradykinesia, tremors, gait, and balance. It’s best to do this to get a full picture of the patient before conducting or escalating them to another professional for scans.
Parkinson’s Rigidity Test Example
To help you perform the Parkinson’s Rigidity Test, we have created a free downloadable template. You can use it after conducting each part of the test to note down your findings.
Our sheet template contains the instructions for performing the two parts of this test. You probably don’t need these instructions because you’re likely (and supposedly) knowledgeable about performing this, but we all have our days. So, they are there to serve as refreshers in case you need them.
More importantly, the template has spaces to write your observations per segment. You can indicate what type of rigidity the patient is dealing with based on the resistance of movement, and you can even note down if you had to resort to an activation method.
If you like what you see and believe this sheet is good for your Parkinson’s Disease-related work, please 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 the best time to conduct the Parkinson’s Rigidity Test?
Before you test a patient for Parkinson’s Disease, you must determine if the patient is eligible to undergo Parkinson’s Disease-related tests. For them to be eligible, they need to have the following symptoms:
- Bradykinesia, which is the slowness of movement
- If they are struggling to maintain their balance and are prone to falling
- If there are tremors in their limbs, even while at rest
- And if their arms, legs, and/or trunk are showing signs of rigidity, which is what this test is for
If your patient seems to have these symptoms while with you, that’s the best time to whip out a copy of our Parkinson’s Rigidity Test template and start conducting it.
Do note that this test should be part of a comprehensive examination. The reason for this is that this test alone is not enough to confirm that your patient has Parkinson’s Disease. Any person can have sluggish movements or have a hard time moving their limbs, especially the elderly.
That’s why it’s recommended that you conduct the Bradykinesia Test, Parkinson’s Tremor Test, and even a gait and balance test to check for signs of Parkinson’s Disease before you endorse them for scans and neurological tests.
Comprehensive examinations are critical, given there is a chance you might misdiagnose a patient with Parkinson’s Disease. Based on the findings of 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 misdiagnosing a patient for Parkinson’s Disease, even among experienced neurologists, is twenty-five percent. That’s why it’s best to cover as much ground as possible before making an official diagnosis.
What are the benefits of the Parkinson’s Rigidity Test?
Both segments of the test are easy to perform!
The Parkinson’s Rigidity Test is one of the easiest tests to perform when checking for symptoms and the likelihood of Parkinson’s Disease in a patient. This specific test doesn’t require anything except for two chairs and the healthcare professional’s hands.
All the healthcare professional needs to do is rotate, flex, and extend limbs while trying to feel for any resistance while they passively move them. If rotating, flexing, and extending the limbs won’t activate resistance, the activation method we mentioned earlier should be able to do the trick. That’s it!
It’s a great way to screen patients for the possibility of Parkinson’s Disease.
Before conducting scans and neurological tests to confirm Parkinson’s Disease, it’s always best to check if the patient is exhibiting symptoms of the disease, not just by looking at them but also by conducting specific tests like the Parkinson’s Rigidity Test. This should be one of the first tests conducted because there is a chance that a misdiagnosis can be made, as we mentioned earlier.
The Parkinson’s Rigidity Test, the Bradykinesia Test, and the Parkinson’s Tremor Test will gauge the patients for symptoms of Parkinson’s Disease. If they have these symptoms based on the findings, then they are eligible to take scans and neurological tests. The results should serve as a good grounding to determine the likeliness of patients having the disease.
The Parkinson’s Rigidity Test can be used as a monitoring test later on.
Sadly, Parkinson’s Disease is an affliction with no cure, but it can become manageable! Treatments can involve medicine, physical therapy, and even surgery (though this should be the last option).
Let’s stipulate that you have already developed and implemented a treatment plan for your patient. This treatment plan involves medication and physical therapy. Naturally, you’d want to know how the patient is doing and if the plan is working, so from time to time, you should conduct a routine check-up.
Let’s also stipulate that the patient had noticeable rigidity when you first assessed them. During a routine check-up, you can re-conduct the Parkinson’s Rigidity Test to gauge their rigidity. If there is no longer any resistance when you rotate, flex, and extend their limbs, then it’s safe to say your plan is working. All the more if resistance only pops up when you resort to the activation method. If the resistance is still there when rotating, flexing, and extending, or if the resistance is worse than before, you might want to tweak your plan and see if the changes lead to improvement.
How can Carepatron help you with your Parkinson’s Disease-related work?
If you’re reading this mini-guide and intend to use the template, it’s likely you’re a neurologist or at least someone working with a neurologist. If so, welcome! We hope this guide was helpful as a refresher, and our template can help you record your findings!
While we have you, we’d like to recommend that you take the time to explore the Carepatron platform! We have a wide variety of features that might help you with your Parkinson’s Disease-related work.
One of the features you will come across is our resource repository! It’s filled to the brim with worksheets, assessments (including our template for the Parkinson’s Rigidity Test), survey templates, form templates, templates for notices, progress notes, and much more.
We even have other Parkinson’s Disease-related assessments like the Bradykinesia Test, the Parkinson’s Hand Test (which is the Bradykinesia test but only for the hands), Parkinson’s Tremor Test, and even gait and balance assessments. You can download our templates so you can cover more ground when it comes to assessing your patients. They’re also free, so download as much as you want and need!
If you decide to subscribe to our platform, you’ll be given access to our useful storage system, which allows you to store your clinical documents in a HIPAA-compliant manner! Even if you’re storing them with us, we can’t access them because only you can dictate who can access them besides you.
If you downloaded our Parkinson’s Rigidity Test sheet template, you can store filled-out copies with us! Doing so is essentially the same as creating backups of your files. In the event that you lose your copies, you can redownload them from our storage and reprint them or store them on a new work device (if your previous one got busted).
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!