Dexterity and Parkinson's

Parkinson’s can make using your hands for small movements tricky. Specialist physiotherapist Bhanu Ramaswamy tells us more.

There are 27 bones in each hand and wrist that work together so your hand can move – that’s a lot of coordinated muscle and joint activity. Like many parts of the body, we take them for granted until they start to work less efficiently.

What is dexterity?

Hand movements can be extremely precise and quick. A movement can be something small, like typing a text on your phone, to large movements like grabbing a rail to pull your body up the stairs, or pushing yourself up off a chair.

Our brain coordinates these movements, and this is called dexterity. Your hand, or hands, behave as a steadying force to allow the other part of the hand (or the other hand) to carry out the actual task.

When you button a coat, one hand holds the material and creates the buttonhole gape so the other can grasp the button and push it through. When you reach into your purse or wallet, one hand holds it steady, so the other hand can use precision to pick out a coin or note while separating it from the others.

How does Parkinson's affect dexterity?

In the same way that the cold or arthritis can affect movement, stiffness (rigidity), slowness of movement (bradykinesia) or shaking from a tremor in Parkinson’s can all make hand and wrist movements more difficult.

Parkinson’s can also cause ‘striatal’ hand, where the hand is pulled into an uncomfortable position which makes it harder and sometimes painful to use. 

3 hand exercises to try

- To keep your wrists, hands and palms flexible

  • Place your palms together (as if in prayer).
  • Take a steady breath in, and as you breathe out, lower your shoulders and slowly push your hands against one another. You should feel a slight stretch in your fingers and palms.
  • Hold for 30 seconds and try to maintain even pressure on each side. Make sure that your stronger hand doesn’t push the other one sideways.
  • To make it more challenging, raise your elbows out towards the shoulders so the wrists are stretched further.

Now repeat the same exercise above, but incorporate your arms.

  • Link your fingers, then turn your hands so your palms are facing away from your body, and push your arms out.
  • Stretch your arms gently. Try not to raise your shoulders.
  • Try and hold for 30 seconds.

- Before doing small movements such as doing up zips or buttons

  • Shake out your hands to loosen them up.
  • Create a tight fist then stretch your fingers and palms out.
  • On both hands, touch the tip of each finger to the tip of the thumb. Repeat this movement and slowly get faster.
  • Make sure both hands keep the same timing and size of movement.
  • Repeat.

- If your grip is a problem, rather than movement

  • Hold a sheet of paper between your thumb and first two fingers.
  • Using your other hand, try and pull the paper from your grip. Hold the paper tight to prevent this from happening.
  • Try it with different objects, such as a mug or a ball.
  • Repeat with other hand.