Parkinson’s Hand Test

What is a Parkinson's Disease Hand Test?

The Parkinson’s Hand Test is a type of Parkinson’s test that focuses on the hands. It can be any one of the following tests:

• Finger tapping: The patient will repeatedly tap their thumb and index finger repeatedly for a set amount of time, depending on the healthcare professional (which is up to the healthcare professional). They need to do this by alternating finger-tapping movements with both hands.
• Hand grip: This is also known as the fist open-close test. The patient opens and closes their fists repeatedly, also for a set amount of time. They 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.

This test is meant to assess bradykinesia, a symptom of Parkinson’s disease that 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 results of tests, especially the finger tapping test, when done with a nuanced understanding, can reveal critical information about the presence of slower proximal and distal movements as well as the severity of bradykinesia, tremors, and rigidity-key clinical features of Parkinson's disease.  

How to perform the Parkinson's Hand Test?

After you obtain a copy of the template for the Parkinson’s Hand Test, instead of doing just one of the aforementioned tests, you will do all three. Here are step-by-step instructions to guide you as you perform the test, which you can also find in the guide you downloaded:

Step 1: Prepare your patient and needed equipment

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.

Step 2: Conduct the finger-tapping test

During this Parkinson's disease finger test or finger-tapping task, you will simply have your patient perform finger-tapping movements by tapping 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 for at least 10 seconds per hand.

As for you, you will need to observe the finger-tapping speed and accuracy.

Step 3: Conduct the hand grip test

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.

Step 4: Conduct the hand pronation/supination test

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.

Step 5: Record results and proceed to the next steps

Conduct the test and document the results by selecting either the negative or positive outcome as indicated in the template. Consider recording a finger-tapping video to analyze the patient's movements in detail and compare them with baseline recordings over time.

Afterward, you should conduct the heel-tapping and toe-tapping tests to get a full picture of the patient’s condition. Other things to consider include rigidity, gait abnormalities, balance abnormalities, and tremors. Please assess the patient for those as well before conducting DAT Scans, single-photon emission computerized tomography (SPECT) scans, and the Movement Disorder Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS).

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. To be eligible, they must exhibit the following motor symptoms that indicate early Parkinson's disease:

• Bradykinesia (the slowness of movement), which is what these hand tests are designed to check
• Trouble balancing, or if they have fallen and are now prone to falling as a result
• Tremors in their limbs even while they’re at rest
• 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 slow movement, especially if they’re old.

What are the benefits of the Parkinson's Hand Test?

Though it cannot solely diagnose Parkinson's disease, there are still numerous benefits to conducting the Parkinson's hand test. Here are some of them:

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 the patient must perform the instructions for ten seconds per hand.

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.

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 and the patient afflicted with the disease can still improve their quality of life despite having it. Treatment can involve medication, physical therapy, deep brain stimulation, and even surgery.

Valuable in research settings

Beyond helping with clinical diagnosis and monitoring, the test is also valuable in research settings. Machine learning algorithms can analyze the test results to identify patterns associated with Parkinson’s disease. This advanced analysis can lead to the development of new treatments and a deeper understanding of the disease.