Slowness of movement ("bradykinesia") is the most important deficit
in Parkinson's disease (PD). Current clinical rating of
bradykinesia in PD does not separate the dimensions of slowness and
amplitude reduction. We categorized patterns of movement in PD
patients on a biaxial classification of speed and amplitude using
an electromagnetic tracking device (Polhemus) seeking to determine
whether these categories may differentially contribute to motor
impairment and disability. Motor impairment was worst in patients
with very impaired amplitude and best in patients with normal
amplitude. Categories of speed impairment did not show a similar
relationship. The Schwab & England disability scale decreased
with higher severity levels of the amplitude category but not of
speed. Agreement (unweighted kappa) between clinician and
Polhemus-derived speed-amplitude classification were moderate for
speed and amplitude classifications. Our observations suggest that
amplitude and speed impairments might behave differentially in PD
and may deserve consideration in a biaxial classification system.
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