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Parkinson's Exam
 
 

Hand Movements

 
 
 
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Bradykinesia / Hypokinesia

Bradykinesia refers to progressive slowness of movement, while hypokinesia refers to progressive smallness of movements.
These findings are decremental, meaning that they worsen as they are repeated.
  • How to Perform

    Ask the patient to perform a variety of tasks as rapidly as possible:
  • Opening and closing the hand
  • Tapping the thumb and index fingers together
  • Pronating and supinating the hand
  • Look For

  • Progressive slowing and smallness of movement with repetition of the task.

Micrographia

  • How to Perform

  • Ask the patient to write a sentence on a piece of paper.
  • Interpretation

  • Classically, patients with Parkinsonism will start writing a sentence normally, and during the sentence their writing will become smaller and smaller, due to bradykinesia and hypokinesia.
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