Scott D Newsome1, Gloria von Geldern2, Haochang Shou3, Moira Baynes4, Rhul E R Marasigan5, Peter A Calabresi4, Kathleen M Zackowski6. 1. Department of Neurology, Johns Hopkins University, Baltimore, MD, USA. Electronic address: snewsom2@jhmi.edu. 2. Department of Neurology, University of Washington, Seattle, WA, USA. 3. Department of Biostatistics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA. 4. Department of Neurology, Johns Hopkins University, Baltimore, MD, USA. 5. Kennedy Krieger Institute, Baltimore MD, USA. 6. National MS Society, New York, NY, USA; Kennedy Krieger Institute, Baltimore MD, USA; Department of Physical Medicine and Rehabilitation, Johns Hopkins University, Baltimore, MD, USA.
Abstract
OBJECTIVE: Little is known about the frequency and severity of hand dysfunction in individuals with multiple sclerosis (MS). Hence, we sought to determine the extent that quantitative tests of hand function detect changes over time, evaluate their relationship to global disability measures, and identify predictors of hand function. METHODS: One-hundred and forty-seven individuals with MS were included (96 women, 84 relapsing-remitting MS [RRMS]) along with 35 age-and-sex matched controls. Quantitative tests of hand function (grip strength, pinch strength, 9 hole peg test [9HPT], finger tapping) and leg strength were acquired and normalized to age and sex. Expanded Disability Status Scale (EDSS) and timed 25 foot walk were also obtained. Spearman correlations, multivariate regression models and mixed effects linear regression were used for analysis. RESULTS: Our cohort had an EDSS of 3.6 ± 2.2 (median ± SD) and age 44.6 ± 11.9 years. Follow up time was up to 5 years. At baseline, 14/63 individuals with progressive MS (PMS) required more than twice as much time to complete the 9HPT using their dominant hand, compared to controls. Similarly, 11 individuals with PMS had less than 50% of grip strength and 6 had less than 50% of pinch strength, compared to controls. Additionally, 7 individuals with PMS were found to be at least 50% slower than controls in finger tapping. Over two years, 27/85 individuals with MS had more than 20% worsening in their 9HPT results from baseline (17 RRMS, 10 PMS) and 37/74 (20 RRMS, 17 PMS) had more than 20% worsening in their grip strength compared to baseline. CONCLUSIONS: Hand function is commonly impaired in individuals with MS. Assessing hand dysfunction with dynamometry and the 9HPT could help improve the precision of detecting changes in hand function over time in MS, and may be more sensitive in detecting changes in PMS. These quantitative tests may be useful as outcome measures in clinical trials using neuroprotective or reparative therapies and rehabilitative interventions.
OBJECTIVE: Little is known about the frequency and severity of hand dysfunction in individuals with multiple sclerosis (MS). Hence, we sought to determine the extent that quantitative tests of hand function detect changes over time, evaluate their relationship to global disability measures, and identify predictors of hand function. METHODS: One-hundred and forty-seven individuals with MS were included (96 women, 84 relapsing-remitting MS [RRMS]) along with 35 age-and-sex matched controls. Quantitative tests of hand function (grip strength, pinch strength, 9 hole peg test [9HPT], finger tapping) and leg strength were acquired and normalized to age and sex. Expanded Disability Status Scale (EDSS) and timed 25 foot walk were also obtained. Spearman correlations, multivariate regression models and mixed effects linear regression were used for analysis. RESULTS: Our cohort had an EDSS of 3.6 ± 2.2 (median ± SD) and age 44.6 ± 11.9 years. Follow up time was up to 5 years. At baseline, 14/63 individuals with progressive MS (PMS) required more than twice as much time to complete the 9HPT using their dominant hand, compared to controls. Similarly, 11 individuals with PMS had less than 50% of grip strength and 6 had less than 50% of pinch strength, compared to controls. Additionally, 7 individuals with PMS were found to be at least 50% slower than controls in finger tapping. Over two years, 27/85 individuals with MS had more than 20% worsening in their 9HPT results from baseline (17 RRMS, 10 PMS) and 37/74 (20 RRMS, 17 PMS) had more than 20% worsening in their grip strength compared to baseline. CONCLUSIONS: Hand function is commonly impaired in individuals with MS. Assessing hand dysfunction with dynamometry and the 9HPT could help improve the precision of detecting changes in hand function over time in MS, and may be more sensitive in detecting changes in PMS. These quantitative tests may be useful as outcome measures in clinical trials using neuroprotective or reparative therapies and rehabilitative interventions.
Authors: Kathleen M Zackowski; Joseph I Wang; John McGready; Peter A Calabresi; Scott D Newsome Journal: Mult Scler Relat Disord Date: 2015-01 Impact factor: 4.339
Authors: Fernando Dangond; Alexis Donnelly; Reinhard Hohlfeld; Catherine Lubetzki; Susan Kohlhaas; Letizia Leocani; Olga Ciccarelli; Bruno Stankoff; Maria Pia Sormani; Jeremy Chataway; Federico Bozzoli; Francesco Cucca; Lisa Melton; Timothy Coetzee; Marco Salvetti Journal: Nat Rev Neurol Date: 2021-01-22 Impact factor: 42.937