Assessment of leg muscle activity using toe tapping in patients with Parkinson's disease: comparison of two types of toe tapping.
Seira Taniguchi, Ferdinand Peper, Tetsuya Shimokawa
PMID 29765181WHAT IT FOUND
Closed toe tapping did not separate groups by EMG values, except the first gastrocnemius reading was higher in Parkinson's patients.
Open tapping showed higher tibialis anterior EMG burst values than controls. This small study is not enough to change care.
Key findings
01Open toe tapping showed significantly higher tibialis anterior EMG burst values in Parkinson's patients than controls (CV 0.19 vs 0.12).
02Closed toe tapping showed no significant differences in CV between groups, but the first tap's gastrocnemius local minima were higher in Parkinson's patients (0.228 vs 0.076; p=0.038).
03In open tapping, the CV of tibialis anterior EMG bursts was significantly associated with levodopa dose (r=0.75) and H&Y scale (r=0.69).
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
Only 11 people with Parkinson's disease and 9 healthy controls were studied, so the findings are exploratory and may not be stable. The paper reports multiple EMG comparisons and correlations without stating a primary outcome, so it is unclear which finding was the main planned test. All Parkinson's patients were taking levodopa and tested in a self-assessed on-state, so the results may not apply to off-state or medication-naive patients. The Parkinson's group had mean age 73.0 years and the control group mean age 64.6 years, so age differences may have influenced muscle activity. The study measured EMG during toe tapping and clinical scores, not actual gait outcomes, so it does not show that toe tapping EMG predicts walking.
Declared interests
The authors declared no conflict of interest. No funding source is stated in the paper.
The easy way to misread this
Do not use toe tapping EMG to diagnose Parkinson's disease or guide treatment. The study included 11 patients and 9 controls, did not test diagnostic accuracy or gait outcomes, and reported EMG differences and correlations that need confirmation.