Sensitivity and specificity of different hand positions to assess upper limb rest tremor

Movement Disorders : Official Journal of the Movement Disorder Society
Miguel WilkenMarcelo Merello

Abstract

Hand position for rest tremor evaluation in PD is not standardized. We evaluated the sensitivity and specificity of different hand positions commonly used to evaluate rest tremor. Twenty patients with PD and rest tremor were included as cases and 20 patients with essential tremor without rest tremor as controls. Video and accelerometric recordings were conducted in semiprone, completely prone, and with hands hanging down from armrest positions. Three movement disorder specialists rated tremor in each different position using Movement Disorder Society UPDRS items 3.17 and 3.18. Hands hanging showed the highest amplitude (P = 0.004) and constancy (P = 0.015) scores. Sensitivity and specificity analysis for each position showed the following sensitivity/specificity results: semiprone, 95%/80%; completely prone, 85%/98.33%; and hands hanging, 96.66%/63.33%, respectively. The hands-hanging position was shown to be the most suitable for evaluating rest tremor amplitude in PD, whereas the completely prone position proved to be more specific to detect rest tremor. The preferred hand position would depend on the purpose of the examination. © 2019 International Parkinson and Movement Disorder Society.

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Citations

Jun 18, 2019·Movement Disorders : Official Journal of the Movement Disorder Society·Zakia Jabarkheel, Aparna Wagle Shukla
Apr 25, 2020·Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology·Navnika Gupta, Sanjay Pandey
Apr 3, 2021·Parkinsonism & Related Disorders·Alessandro F FoisVictor Sc Fung

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