Hand Grasping Techniques on Eliciting the Grasp Reflex in Patients With Dementia

Study Overview
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Brief Summary
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In this study, the investigators will determine the difference between the two techniques used to elicit the grasp response in patients with frontal lobe dysfunction, primarily in dementia patients versus control patients.

Detailed Description
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The goal of this project is to determine the optimal technique to elicit the grasping response in patients with dementia or suspected frontal lobe dysfunction. The proposed study is to perform two techniques to elicit grasp response in patients with dementia or suspected frontal lobe dysfunction and observe the presence or absence of the response and prominence of the response on a proposed rating scale. Future goals will be aimed at aiding clinicians in refining their clinical techniques to be more sensitive for diagnosing frontal lobe dysfunctions.

Official Title
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The Effect of Hand Grasping Techniques on Eliciting the Grasp Reflex in Patients With Dementia or Suspected Frontal Lobe Dysfunction

Conditions
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Dementia

Intervention / Treatment
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* Other: palmar grasp without dorsal stimulation
* Other: standard palmar grasp test with dorsal stimulation


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Ability to sign informed consent or have a surrogate present to sign the consent Age 18 or above Patients are diagnosed with dementia, Alzheimer's disease, or frontal lobe dysfunction Medications are to remain stable during the course of the study except for emergency modifications. Exclusion Criteria: Inability to obtain informed consent from patient or surrogate Unable to follow commands. Physical restrictions (i.e. spasticity of hands/arms, upper extremity amputation) Other comorbidities such as muscular diseases, hepatic encephalopathy, renal failure, down syndrome, NPH, depression, and cerebral palsy.

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Other: Standard<br>Prospective, grasp techniques will be compared in each patient from the experimental group using a palmar grasp without dorsal stimulation and a standard palmar grasp test with dorsal stimulation on the same patient as the control group | Other: palmar grasp without dorsal stimulation<br>* The patient will then be asked to keep the arms at 90 degrees and the researcher will slightly stroke palm and fingers of both hands of the patient simultaneously. After completion of each technique, the presence or absence of the response will be noted. In addition, the prominence of the response on the rating scale will be obtained as explained below. The scaling of the grasp response is as followed: Flexion at the distal interphalangeal joint of the hand Flexion at the proximal interphalangeal joint of the hand Flexion at the metacarpal-phalangeal joint of the hand<br>Other: standard palmar grasp test with dorsal stimulation<br>* The patient will be asked to put their arms at 90 degrees and the researcher will hold one hand at the wrist and dorsum of the palm and lightly stroke the palm and fingers. The patient will be instructed to relax hands and not hold on while doing the grasp and see if the response persists. The same technique will be repeated for the patient's other hand.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Grasp response | The primary objective of the study will be to determine if a change in the performance of the grasp response will lead to a change in the way the response is elicited. The prominence of the grasp response will be scored on a rating scale | six months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Frontal Lobe release- Glabellar Response | The secondary objective during this study will be to determine if other frontal release signs are present in study participants. The glabellar response will be tested. | six months | 
| Frontal lobe release- Palmomental Response | The secondary objective during this study will be to determine if other frontal release signs are present in study participants. The palmomental response will be tested. | six months | 
| Frontal lobe release- Snout Response | The secondary objective during this study will be to determine if other frontal release signs are present in study participants. The snout response will be tested. | six months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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dementia