John W Farrell1, Robert W Motl2, Yvonne C Learmonth3, Lara A Pilutti4. 1. Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, ON, CDN. 2. Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana-Champaign, IL, USA. 3. Discipline of Exercise Science, College of Science, Health, Engineering and Education, Murdoch University, Murdoch, WA, Australia; Perron Institute for Neurological and Translational Science, Perth, WA, Australia; Centre for Molecular Medicine and Innovative Therapeutics, Murdoch University, Murdoch, WA, Australia. 4. Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana-Champaign, IL, USA. Electronic address: lpilutti@uottawa.ca.
Abstract
OBJECTIVE: To characterize strength asymmetries in the upper and lower extremities in persons with multiple sclerosis (PwMS) with severe disability, and examine associations between asymmetries and functional, symptomatic, and participatory outcomes. DESIGN: Cross-sectional. SETTING: University research laboratory. PARTICIPANTS: 25 PwMS with Expanded Disability Status Scale scores between 6.0-8.0. MAIN OUTCOME MEASURES: Bilateral strength and asymmetry scores for muscle groups at the ankle, knee, and shoulder joints in addition to grip strength. RESULTS: Significant differences were observed between all contralateral strength measures, with asymmetry scores ranging between 20-32%. A high prevalence of asymmetry (i.e., score>10%) was observed for all strength measures, with 92% of participants having four or more affected measures. Significant associations were observed between dorsiflexion asymmetry and physical health-related quality of life (ρ= -0.69; p<0.001), and between shoulder flexion asymmetry and lower extremity function (ρ= -0.62; p=0.001). Plantarflexion (ρ= 0.61; p=0.003) and knee flexion (ρ= 0.63; p=0.002) asymmetry were significantly associated with lower extremity functional asymmetry. CONCLUSIONS: A high prevalence of asymmetry in the upper and lower extremities was observed, with asymmetry scores exceeding those previously reported in PwMS with mild-to-moderate disability. Rehabilitation strategies should consider a full body approach to address strength asymmetries.
OBJECTIVE: To characterize strength asymmetries in the upper and lower extremities in persons with multiple sclerosis (PwMS) with severe disability, and examine associations between asymmetries and functional, symptomatic, and participatory outcomes. DESIGN: Cross-sectional. SETTING: University research laboratory. PARTICIPANTS: 25 PwMS with Expanded Disability Status Scale scores between 6.0-8.0. MAIN OUTCOME MEASURES: Bilateral strength and asymmetry scores for muscle groups at the ankle, knee, and shoulder joints in addition to grip strength. RESULTS: Significant differences were observed between all contralateral strength measures, with asymmetry scores ranging between 20-32%. A high prevalence of asymmetry (i.e., score>10%) was observed for all strength measures, with 92% of participants having four or more affected measures. Significant associations were observed between dorsiflexion asymmetry and physical health-related quality of life (ρ= -0.69; p<0.001), and between shoulder flexion asymmetry and lower extremity function (ρ= -0.62; p=0.001). Plantarflexion (ρ= 0.61; p=0.003) and knee flexion (ρ= 0.63; p=0.002) asymmetry were significantly associated with lower extremity functional asymmetry. CONCLUSIONS: A high prevalence of asymmetry in the upper and lower extremities was observed, with asymmetry scores exceeding those previously reported in PwMS with mild-to-moderate disability. Rehabilitation strategies should consider a full body approach to address strength asymmetries.
Authors: Kora Portilla-Cueto; Carlos Medina-Pérez; Ena Monserrat Romero-Pérez; José Aldo Hernández-Murúa; Claudia Eliza Patrocinio de Oliveira; Fernanda de Souza-Teixeira; Jerónimo J González-Bernal; Carolina Vila-Chã; José Antonio de Paz Journal: Int J Environ Res Public Health Date: 2020-11-02 Impact factor: 3.390