Claudio Solaro1, Davide Cattaneo2, Giampaolo Brichetto3, Letizia Castelli4, Andrea Tacchino3, Elisa Gervasoni2, Luca Prosperini5. 1. Rehabilitation Unit, "Mons. L. Novarese" Hospital, Loc. Trompone, 13040 Moncrivello, VC, Italy. Electronic address: csolaro@libero.it. 2. Larice Lab - IRCCS Don Gnocchi Foundation, Milan, Italy. 3. Scientific Research Area, Italian MS Society Foundation, Genoa, Italy. 4. Dept. of Neurology and Psychiatry, Sapienza University, viale dell'Università 30, 00185 Rome, Italy. 5. Dept. of Neurosciences, S. Camillo-Forlanini Hospital, c.ne Gianicolense 87, 00152 Rome, Italy.
Abstract
OBJECTIVE: To assess the distribution of nine hole peg test (9-HPT) and its clinical correlates in a large sample of patients with multiple sclerosis (MS). METHODS: Data was collected in a multi-centre, cross-sectional study involving 4 Italians MS centres. We collected demographic and clinical data of 363 patients (244 women, 199 men), including year of symptom onset, disease course, Expanded Disability Status Scale (EDSS). RESULTS: A total of 206 (61.3%) patients scored ≥2 standard deviations (SDs) of normative values in both hands, while only 38 (11.3%) scored <1 SD from normative values at 9-HPT. We found ceiling and floor effects in mildly (EDSS < 3.0) and severely (EDSS > 6.0) impaired patients. Patients with a primary progressive disease course and those with a more severe disability level showed the large between-hand asymmetry. In multivariate models, predictors of unimanual and bimanual impairments were primary progressive course (odds ratio [OR] = 7.27, p = 0.001) and higher EDSS score (OR = 2.13 for each step, p < 0.001), respectively. CONCLUSION: We suggest that 9-HPT should be used with caution in patients with low or high disability levels. Between-hand asymmetry and stratification for age, disease course, and presence/absence of bilateral involvement should be taken into account for future study design.
OBJECTIVE: To assess the distribution of nine hole peg test (9-HPT) and its clinical correlates in a large sample of patients with multiple sclerosis (MS). METHODS: Data was collected in a multi-centre, cross-sectional study involving 4 Italians MS centres. We collected demographic and clinical data of 363 patients (244 women, 199 men), including year of symptom onset, disease course, Expanded Disability Status Scale (EDSS). RESULTS: A total of 206 (61.3%) patients scored ≥2 standard deviations (SDs) of normative values in both hands, while only 38 (11.3%) scored <1 SD from normative values at 9-HPT. We found ceiling and floor effects in mildly (EDSS < 3.0) and severely (EDSS > 6.0) impaired patients. Patients with a primary progressive disease course and those with a more severe disability level showed the large between-hand asymmetry. In multivariate models, predictors of unimanual and bimanual impairments were primary progressive course (odds ratio [OR] = 7.27, p = 0.001) and higher EDSS score (OR = 2.13 for each step, p < 0.001), respectively. CONCLUSION: We suggest that 9-HPT should be used with caution in patients with low or high disability levels. Between-hand asymmetry and stratification for age, disease course, and presence/absence of bilateral involvement should be taken into account for future study design.
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