Background Huntington's disease (HD) causes severe motor impairments that are characterized by chorea, dystonia, and impaired fine motor control. These motor deficits have been described in clinical settings and studied in formal laboratory-based tasks, and include deficits in the control of the arm and hand.
Aim The goal of our study was to examine skilled reaching behaviour and upper body movements of HD and control subjects in a real-world reach-to-eat task. Motor performance was evaluated by a movement element rating scale.
Methods Twelve HD subjects and twelve age-matched controls were video-recorded performing a reach-to-eat task in which all subjects reached for a small food item, with the left or the right hand, and then brought it to the mouth for eating. Orientation to the target, limb transport, grasping, limb withdrawal and the release of the food to the mouth were analyzed frame-by-frame by scoring the video footage using an established movement element rating scale and by kinematic analysis to describe limb trajectory.
Results HD subjects were variable in their performance. They displayed an overall jerkiness, a significant impairment in end point error correction (that is no smooth trajectories), deficits in timing and terminating motion (overshooting at target), impairments in rotation of the hand, and abnormalities in grasping and releasing the food item.
Conclusions The quantification provided by the movement rating scale gives an easy and inexpensive way to document skilled limb movement impairments of the upper extremities in HD in a real-world context. Therefore, our protocol can serve as a useful clinical tool to evaluate innovative therapeutic interventions in HD such as physiotherapy, drug therapy or functional neurosurgical procedures.
- Skilled limb movement
- neurodegenerative disease
- reaching behavior
- Huntington's disease
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