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The Impact of Paratonia on Fine and Gross Motor Function in Older Adults With Mild and Moderate Dementia

Van Deun, Bieke, MSc*; Van Den Noortgate, Nele, PhD; Van Bladel, Anke, PhD*; Palmans, Tanneke, MSc*; Cambier, Dirk, PhD*

Alzheimer Disease & Associated Disorders: January-March 2019 - Volume 33 - Issue 1 - p 54–61
doi: 10.1097/WAD.0000000000000278
Original Articles

Background: Dementia is associated with impairment in gait, balance, and fine motor function. Paratonia, a form of hypertonia, is often present in severe dementia. However, little is known about muscle tone in early dementia, and the eventual relation between muscle tone abnormalities and changes in fine and gross motor function.

Methods: Three groups of participants were included in the study: healthy controls (n=60), participants with mild dementia (MiD) (n=31), and participants with moderate dementia (n=31). Measurements of fine motricity (Purdue pegboard test), balance and gait (Dynaport Hybrid), the presence of paratonia (PAI), and muscle tone measurements (MyotonPRO) were performed.

Results: Paratonia was present in 42% of participants with MiD and in 58% of participants with moderate dementia. Participants with paratonia had lower Purdue Pegboard scores (P<0.001), lower balance coordination in semitandem stance (P<0.001), lower walking speed at a fast pace (P=0.001), and lower step regularity at normal (P=0.025) and fast (P<0.001) pace.

Conclusions: Paratonia is already present in participants with MiD and is associated with a decline in both fine and gross motor performance. Early detection of paratonia might be helpful to detect persons at higher risk of motor deterioration and falls.

*Department of Rehabilitation Sciences and Physiotherapy, Ghent University

Department of Geriatrics, Ghent University Hospital, Ghent, Belgium

The authors declare no conflicts of interest.

Reprints: Bieke Van Deun, MSc, Department of Rehabilitation Sciences and Physiotherapy, Campus UZ Gent, 1B3, entrance 46, Corneel Heymanslaan 10, B-9000 Ghent, Belgium (e-mail:

Received March 29, 2018

Accepted September 4, 2018

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