The ability to perform tasks that require fine motor skills using the fingers and hands. This ability gradually diminishes in Parkinson’s disease. An early indicator of Parkinson’s is difficulty in performing repetitious tasks that require dexterity, such as tapping the fingers in sequence. The loss of dexterity typically is asymmetrical (unilateral or single-sided), or more pronounced on one side of the body than the other. The person may not notice a problem if the loss affects the nondominant hand. When dexterity loss is minimal, as in the early stages of Parkinson’s, compensation occurs without conscious awareness. The person may shift to the nonaffected hand for tasks such as fastening buttons or picking up change. Loss of dexterity affects handwriting, causing the characteristic micrographia, a small, cramped writing style, that is sometimes the first sign that dexterity is reduced. Hand-eye coordination is another dimension of dexterity that suffers in Parkinson’s when the disease affects control of eye muscles.
As do other motor symptoms of Parkinson’s, dexterity progressively worsens as the disease progresses. Treatment with anti-parkinson’s medications to some extent but not entirely restores dexterity as it improves other symptoms such as tremors and bradykinesia, but loss of dexterity remains an obvious and frustrating problem for people with Parkinsons’s. As treatment becomes less effective in controlling tremors, those that affect the hands further compound the loss of dexterity. Any activity that exercises dexterity, such as typing or putting together jigsaw puzzles, keeps fine motor ability at a higher level than inactivity. Switching to large-diameter pencils and pens and printing instead of writing in script can compensate for micrographia. occupational therapy can teach adaptive methods and strengthening exercises.
