## 4 Discussion  
Our research showed that in patients suffering from Parkinson's disease, the myotonometric parameters (frequency, stiffness and decrement) of the major pectoralis, biceps brachialis, femoral biceps and anterior tibialis, assessed in the morning before drug administration, had significantly higher values in comparison to age- and gender-matched healthy controls. We chose the above-mentioned muscle groups as they are involved in postural stability, thus affecting the everyday activities in Parkinson's disease patients. When analyzing the within-group myotonometric parameters (before medical treatment and an hour after taking the medication), the patients' group reported a state of muscular tension (frequency), a muscular rigidity (stiffness) and a value of elasticity (decrement) significantly higher than before treatment. When considering the decrement, the bigger the value, the more the muscle cannot come back to the relative shape rapidly between two contractions. Thus, fatigue and movement limitation occurs due to the lack of elasticity. These elements change the grade of the patient's functionality in daily activities, because the patient must make a more considerable effort in doing an activity due to muscular tension (frequency) and increased rigidity (stiffness). There were no statistically significant differences between pre and post treatment for all the myotonometric parameters. To our knowledge, this is the first study to use the myotomometric assessment of four different muscle groups in [PERSON]'s disease patients. [PERSON] and [PERSON] assessed the extensor digitorum muscle in six patients with advanced-stage [PERSON]'s disease. They concluded that increased rigidity is associated with increased values of viscoelastic stiffness in patients with [PERSON]'s disease [13]. The scientific literature includes the use MyotonPRO technology to determine the specificity of the parameters, such as a study done by [PERSON] et al. [21]. This study on 21 patients followed the negative effects of different postures involuntarily adopted by the patients at the level of trapezius muscles, provoking muscle rigidity. The results showed the grade of rigidity, depending on the maintained antalgic position. After the obtained results by means of MyotonPRO technology, it was identified in what measure the muscle rigidity triggers discomfort, pain and fatigue and how maintaining the correct position of the neck and back would decrease the level of rigidity [21]. Another study on 18 patients ([PERSON] et al., 2010) analyzed the passive rigidity of the biceps brachialis muscle in a group of women with [PERSON]'s disease in comparison with a group of healthy women. Myotonometry, electromyography and mechanomyog \begin{table}
\begin{tabular}{c c c c} \hline \hline
**MyotonPRO** & **Age of** & **Duration of** & **Functional Status** \\
**Parameter** & **Disease Onset** & **the Disease** & **MDS-UPDRS** \\ \hline Frequency & r = 0.13 & r = 0.07 & r = 0.16 \\  & \(p\) = 0.08 & \(p\) = 0.36 & \(p\) = 0.03 \\ \hline Stiffness & r = 0.10 & r = 0.04 & r = 0.09 \\  & \(p\) = 0.15 & \(p\) = 0.56 & \(p\) = 0.20 \\ \hline Decrement & r = \(-\)0.17 & r = 0.007 & r = 0.16 \\  & \(p\) = **0.02** & \(p\) = 0.92 & \(p\) = **0.03** \\ \hline Relaxation & r = \(-\)0.07 & r = 0.04 & r = 0.001 \\  & \(p\) = 0.33 & \(p\) = 0.57 & \(p\) = 0.98 \\ \hline Creep & r = \(-\)0.05 & r = 0.04 & r = 0.005 \\  & \(p\) = 0.46 & \(p\) = 0.59 & \(p\) = 0.94 \\ \hline \hline \end{tabular} MDS-UPDRS: Movement Disorder Society-Unified Parkinson’s Disease Rating Scale; Bold values: \(p\) \(<\) 0.05 indicates statistical significance.  
\end{table} 
Table 12: Correlations between myotonometric parameters and patients’ characteristics. raphy were used for assessment. Results showed that myotonometry provides valuable evaluation due to its sensitivity, as it detects muscle rigidity [14]. [PERSON] et al. studied the relation between the dopaminergic dose treatment and the mechanical properties (myotonometry) of elbow flexor muscles.