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Erin E. Jobst, MPT; Marsha E. Melnick, PhD; Nancy N. Byl, PhD; Glenna A. Dowling, PhD; Michael J. Aminoff, MD, FRCP

Arch Neurol. 1997;54(4):450-454.

Abstract
Objective
To determine whether there is a complex sensory disturbance that may be contributing to the motor deficit in patients with Parkinson disease.

Design
Comparison of performance by patients and healthy, age- and sex-matched subjects in tests of various sensory functions.

Setting
The Center for Human Performance and Testing at a university hospital and research center.

Participants
Ten subjects with Parkinson disease and 10 control subjects matched for age and sex.

Main Outcome Measure
Performance on 4 subtests of the Sensory Integration and Praxis Test: finger identification, graphesthesia, localization of tactile stimuli, and kinesthesia.

Results
Data were analyzed using paired t tests for ratio data and the paired Wilcoxon test for ordinal data. Patients with Parkinson disease performed significantly worse (P=.001) than the control patients on the test of kinesthesia. There were no significant differences between the 2 groups on the other subtests.

Conclusions
Without visual guidance, patients with Parkinson disease had more difficulty in perceiving the extent of a movement made to a target away from the body, a task requiring reliance on proprioceptive feedback. Parkinsonian patients had no more difficulty than controls in making movements to a target on the surface of the body when they could use tactile sensations. Movement difficulties in patients with Parkinson disease may relate in part to a decrease in proprioception. Activities that enhance kinesthetic awareness may be an important adjunct to the treatment of these patients.

Author Affiliations
From the Graduate Program in Physical Therapy (Ms Jobst and Drs Melnick and Byl), and the Departments of Neurology (Drs Dowling and Aminoff) and Physiologic Nursery (Dr Dowling), University of California, San Francisco.

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