Rita Bertoni1, Ilse Lamers2, Christine C Chen3, Peter Feys2, Davide Cattaneo4. 1. LaRiCE lab: Gait and Balance Disorders Laboratory, Don Gnocchi Foundation, I.R.C.C.S., Italy. 2. REVAL - Rehabilitation Research Institute, BIOMED - Biomedical Research Institute, Faculty of Medicine and Life Sciences, Hasselt University, Belgium. 3. Rehabilitation Sciences (Occupational Therapy), University of Texas at El Paso, El Paso, Texas. 4. LaRiCE lab: Gait and Balance Disorders Laboratory, Don Gnocchi Foundation, I.R.C.C.S., Italy dcattaneo@dongnocchi.it.
Abstract
BACKGROUND: There has been limited research on upper limb dysfunction in people with multiple sclerosis (PwMS). OBJECTIVE: The objective of this paper is to study unilateral and bilateral upper limb dysfunction at different International Classification of Functioning (ICF) levels according to overall disability in PwMS. METHODS: A total of 105 PwMS (16 with EDSS<4 (mild); 17 with EDSS 4-5.5 (moderate); 37 with EDSS 6-6.5 (severe); 35 with EDSS>6.5 (severe non-ambulant)) were recruited from two rehabilitation centers and assessed in a cross-sectional study. RESULTS: The whole sample showed a diminished sensory function (median (first/third interquartile)) score of 3 (2/3) on the Monofilament Test and a reduced strength 91 (76/100) points on the Motricity Index (Body-Function level). Sensory dysfunction did not increase with higher EDSS while strength decreased from 100 (86/100) in the mild subgroups to 91 (80/100) points in the severe subgroup. All showed diminished dexterity, scoring 0.28 peg/s (0.17/0.35) on the Nine-Hole Peg Test (NHPT) (activity level). Score was better for the mild (0.38 (0.35/0.46)) peg/s compared to the severe subgroup (0.28 (0.17/0.35)). Sixty-eight percent, 44% and 75% of PwMS showed bilateral disorders in sensation, strength and dexterity, respectively. The Community Integration Questionnaire (participation level) showed a 35% reduction in home activities, even among PwMS with EDSS<4. CONCLUSION: This study showed uni-/bilateral upper limb abnormalities at all ICF levels increasing with the overall disability.
BACKGROUND: There has been limited research on upper limb dysfunction in people with multiple sclerosis (PwMS). OBJECTIVE: The objective of this paper is to study unilateral and bilateral upper limb dysfunction at different International Classification of Functioning (ICF) levels according to overall disability in PwMS. METHODS: A total of 105 PwMS (16 with EDSS<4 (mild); 17 with EDSS 4-5.5 (moderate); 37 with EDSS 6-6.5 (severe); 35 with EDSS>6.5 (severe non-ambulant)) were recruited from two rehabilitation centers and assessed in a cross-sectional study. RESULTS: The whole sample showed a diminished sensory function (median (first/third interquartile)) score of 3 (2/3) on the Monofilament Test and a reduced strength 91 (76/100) points on the Motricity Index (Body-Function level). Sensory dysfunction did not increase with higher EDSS while strength decreased from 100 (86/100) in the mild subgroups to 91 (80/100) points in the severe subgroup. All showed diminished dexterity, scoring 0.28 peg/s (0.17/0.35) on the Nine-Hole Peg Test (NHPT) (activity level). Score was better for the mild (0.38 (0.35/0.46)) peg/s compared to the severe subgroup (0.28 (0.17/0.35)). Sixty-eight percent, 44% and 75% of PwMS showed bilateral disorders in sensation, strength and dexterity, respectively. The Community Integration Questionnaire (participation level) showed a 35% reduction in home activities, even among PwMS with EDSS<4. CONCLUSION: This study showed uni-/bilateral upper limb abnormalities at all ICF levels increasing with the overall disability.
Authors: Ameen Barghi; Jane B Allendorfer; Edward Taub; Brent Womble; Jarrod M Hicks; Gitendra Uswatte; Jerzy P Szaflarski; Victor W Mark Journal: Neurorehabil Neural Repair Date: 2018-03 Impact factor: 3.919
Authors: Victor W Mark; Edward Taub; Gitendra Uswatte; David M Morris; Gary R Cutter; Terrie L Adams; Mary H Bowman; Staci McKay Journal: Neurorehabil Neural Repair Date: 2018-03 Impact factor: 3.919
Authors: Ricardo N Alonso; Maria B Eizaguirre; Leila Cohen; Cecilia Quarracino; Berenice Silva; Maria C Pita; Cecilia Yastremiz; Sandra Vanotti; Orlando Garcea Journal: Int J MS Care Date: 2020-05-15
Authors: Peter Feys; Ilse Lamers; Gordon Francis; Ralph Benedict; Glenn Phillips; Nicholas LaRocca; Lynn D Hudson; Richard Rudick Journal: Mult Scler Date: 2017-02-16 Impact factor: 6.312
Authors: Sophie Cleanthous; Sara Strzok; Farrah Pompilus; Stefan Cano; Patrick Marquis; Stanley Cohan; Myla D Goldman; Kiren Kresa-Reahl; Jennifer Petrillo; Carmen Castrillo-Viguera; Diego Cadavid; Shih-Yin Chen Journal: Mult Scler J Exp Transl Clin Date: 2018-05-17