Limb-kinetic apraxia affects activities of daily living in Parkinson's disease: a multi-center study

Foki, T; Vanbellingen, Tim; Lungu, C; Pirker, W; Bohlhalter, Stephan; Nyffeler, Thomas; Kraemmer, J; Haubenberger, D; Fischmeister, F Ph S; Auff, E; Hallett, M; Beisteiner, R (2016). Limb-kinetic apraxia affects activities of daily living in Parkinson's disease: a multi-center study. European journal of neurology, 23(8), pp. 1301-1307. Blackwell Science 10.1111/ene.13021

[img] Text
ene13021.pdf - Published Version
Restricted to registered users only
Available under License Publisher holds Copyright.

Download (234kB) | Request a copy


Impaired dexterity (fine hand movements) is often present in Parkinson's disease (PD), even at early to moderate disease stages. It has a detrimental impact on activities of daily living (ADL) such as buttoning, contributing to reduced quality of life. Limb-kinetic apraxia, a loss of the ability to make precise, independent but coordinated finger and hand movements, may contribute to impaired dexterity even more than bradykinesia per se. However, the impact of limb-kinetic apraxia on ADL remains controversial. Our aim was to identify the strongest predictor of buttoning and unbuttoning in PD. It was hypothesized that coin rotation (a surrogate of limb-kinetic apraxia) represents the most important determinant.


Sixty-four right-handed, early to moderate PD patients were recruited from three movement disorder centers (Hoehn andYahr stages 1-3). Buttoning, unbuttoning and coin rotation (right and left hand) represented the target tasks. Motor impairment was assessed according to the Unified Parkinson's Disease Rating Scale.


Multiple linear regression analysis showed that coin rotation with the right hand was the only significant predictor of buttoning (P < 0.001) and unbuttoning (P = 0.002). Notably, measures of bradykinesia or overall motor impairment did not represent significant predictors.


Constituting the novel key finding, limb-kinetic apraxia seems to be particularly relevant for ADL requiring dexterity skills in PD, even at early to moderate disease stages. Our results prompt research into the pathophysiological background and therapeutic options to treat limb-kinetic apraxia. The simple coin rotation test provides valuable information about ADL-related dexterity skills.

Item Type:

Journal Article (Original Article)


04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > DCR Unit Sahli Building > Forschungsgruppe Neurologie
04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology
10 Strategic Research Centers > ARTORG Center for Biomedical Engineering Research

UniBE Contributor:

Vanbellingen, Tim, Bohlhalter, Stephan, Nyffeler, Thomas


600 Technology > 610 Medicine & health
500 Science > 570 Life sciences; biology




Blackwell Science




Vanessa Vallejo

Date Deposited:

16 Mar 2017 13:46

Last Modified:

05 Dec 2022 15:02

Publisher DOI:


PubMed ID:


Uncontrolled Keywords:

Parkinson's disease; activities of daily living; buttoning; dexterity; limb-kinetic apraxia




Actions (login required)

Edit item Edit item
Provide Feedback