[johnt]

People with Parkinson's (PwP) often find new symptoms developing or old methods of treatment that worked well in the past are becoming less effective. For instance, your 3 times daily 100mg levodopa/carbidopa drug regimen, that used to work fairly well, is now leaving you with longer and longer "off" periods.

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The side-to-side tap test gives a good, but not perfect, measure of the intensity of your PD motor symptoms at a particular point of time. It involves sitting in front of a lap-top and first using your left-hand index finger only, seeing how many times you can type q followed by p in 30 seconds, and second repeating this procedure using just your right-hand index finger. For a free app to run the test use:

Parkinson's Disease Measurement: PwP, surveys, trials, analysis

Note: high scores are good.

Important. As you repeat the test you learn how to do it better. This learning effect will distort the results. Most of the learning will take place in the first 10 times that you do the test. So, to eliminate this effect do the test 10 times for practice, throwing away the scores, before doing the test for real. You only need to do this once: once you start doing the test regularly the impact of the learning effect is negligible.

You should do this test at a time when your environment is stable. That is: you are not eating and all doses of the drugs that you take are either "finished" (e.g. levodopa/carbidopa has a half-life of about 90 minutes) or having almost constant effect (e.g. rasagiline). To test that this is the case and to get baseline data, run the test three or four times at 10 minute intervals.

If these precautions are followed, the test should be accurate enough to pick-up the effect of taking a dose of levodopa: first nothing appears to change, then after about 30 minutes (it varies from person to person) you notice a distinct improvement, reaching a maximum after about 60 minutes, then plateauing for 3 to 4 hours, before quite rapidly going "off". To test for this take the test at 10 minute intervals throughout this whole period.

What the test does less well is to measure the differences between people. This is because different people attack the test with different levels of enthusiasm.

What the test doesn't do is test for non-motor symptoms.

John