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Biomechanische Analyse zyklischer Handfunktionen

Eine Pilotstudie bei unterschiedlichen Parkinson-Syndromen

A biomechanical analysis of cyclical hand motor function

A pilot study in different Parkinsonian syndromes

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Zusammenfassung

Einleitung

Die Beurteilung der Handbradykinese im Rahmen einer Parkinson-Erkrankung erfolgt über ein visuelles Rating unterschiedlicher Bewegungsaufgaben (Diadochokinese, Handtapping, Zeigefingertapping). Das Ziel dieser Studie ist die Quantifizierung und Beurteilung der Handbradykinese mittels eines kinematischen Messverfahrens von unterschiedlichen Parkinson-Syndromen.

Patienten und Methode

In dieser retrospektiven Studie wurden 18 idiopathische Parkinson-Patienten (IPS), 17 atypische Parkinson-Patienten (APS), 18 sekundäre Parkinson-Patienten und eine gesunde Kontrollgruppe (n = 18) mittels ultraschallbasiertem Messsystem (Zebris® Handfunktion, Isny, Germany) miteinander verglichen. Alle Patienten befanden sich zum Zeitpunkt der Messung in bester medikamentöser Einstellung. Es wurden die Bewegungsfrequenz, -amplitude und -variabilität der Diadochokinese, Hand- und Zeigefingertapping quantifiziert.

Ergebnisse

APS-Patienten hatten signifikant komplexe Handfunktionsstörungen mit reduzierten Amplituden und Geschwindigkeiten in Kombination mit erhöhter Bewegungsvariabilitäten in allen drei Bewegungsaufgaben. Hingegen zeigten IPS-Patienten primär Rhythmusdefizite im Handtapping und im Zeigefingertapping mit moderat reduzierten Bewegungsamplituden und -geschwindigkeiten. Die motorische Handfunktion der SPS-Patienten charakterisierte sich durch eine Bewegungsverlangsamung ohne Amplitudenreduktion mit normaler Bewegungsvariabilität.

Schlussfolgerung

Die Ergebnisse aus der vorliegenden Studie zeigen, dass die Handbradykinese aus unterschiedlichen Parkinson-Syndromen mithilfe der quantitativen Bewegungsanalyse erfasst und ein differenziertes Bewegungsmuster evaluiert werden kann. Der Einsatz im klinischen Alltag ist zur genaueren und differenzierten Beurteilung der Handbradykinese sowie für therapeutische Behandlungsstrategien und Interventionsstudien denkbar.

Summary

Introduction

Clinical assessment of hand bradykinesia in Parkinson’s disease (PD) focuses mainly on the frequency, amplitude and rhythm of movements, thereby subjectively evaluating the correct performance of hand movements. The aim of the study was to quantify hand bradykinesia with kinematic data in different Parkinsonian syndromes.

Patients and Methods

This retrospective study compared patients with idiopathic PD (IPD, n = 18), atypical Parkinson’s syndrome (APS, n = 17), secondary Parkinson’s syndrome (SPS, n = 18) and healthy controls (C, n = 18). All patients were receiving the best medical treatment. Hand movements were recorded using an ultrasound-system (Zebris®, Isny, Germany). Subjects were asked to perform pronation/supination of the forearm (diadochokinesis), flexion/extension of the hand (hand tapping) and tapping of the index finger. Mean amplitude, mean frequency and mean variability of movements were determined.

Results

APS patients had significant complex hand movement disability with reduced amplitude and frequency in combination with increased motion variability in all movement tasks. The key disturbance in the IPD group concerned the rhythm in hand tapping and index finger tapping in combination with moderately reduced velocity and range of motion in all conditions. The cyclical hand movement characteristics in SPS patients showed movement slowness with normal amplitude and variability in all motor conditions.

Conclusion

Our results suggest that computerized quantitative analysis of cyclical hand movements can characterize and identify different representations of hand bradykinesia in different Parkinsonian disorders and hence may help clinicians to accurately assess therapeutic targets and outcome of interventions.

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Authors and Affiliations

  1. Abteilung für Neurologie – Labor für Bewegungsanalyse, Landes-Nervenklinik Wagner-Jauregg, Universitätslehrkrankenhaus, Wagner-Jauregg-Weg 15, 4020, Linz, Österreich

    T. Wolfsegger, I. Rotaru, R. Topakian & F.T. Aichner

  2. Abteilung für Nuklearmedizin, Landes-Nervenklinik Wagner-Jauregg, Universitätslehrkrankenhaus , Linz, Österreich

    R. Pichler

  3. Abteilung für Radiologie, Landes-Nervenklinik Wagner-Jauregg, Universitätslehrkrankenhaus , Linz, Österreich

    M. Sonnberger

  4. Abteilung für Sport- und Bewegungswissenschaften/USI, Universität Salzburg, Salzburg, Österreich

    H. Schwameder

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  1. T. Wolfsegger
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  2. I. Rotaru
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  3. R. Topakian
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  4. R. Pichler
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  5. M. Sonnberger
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  7. H. Schwameder
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Correspondence to T. Wolfsegger.

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Wolfsegger, T., Rotaru, I., Topakian, R. et al. Biomechanische Analyse zyklischer Handfunktionen . Nervenarzt 83, 766–771 (2012). https://doi.org/10.1007/s00115-011-3464-7

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  • DOI: https://doi.org/10.1007/s00115-011-3464-7

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