Quantification of upper limb dysfunction in the activities of the daily living in persons with multiple sclerosis

Pisa, Marco; Ruiz, Jennifer A.; DeLuc, Gabriele C.; Crespo, Marta de Andres; DelMastro, Heather M.; Olson, Kayla M.; Triche, Elizabeth W.; Lo, Albert

doi:10.1016/j.msard.2022.103917

Cited by 8 publications

(5 citation statements)

References 45 publications

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“…The score represents the total time (in seconds) needed to put nine pegs into nine holes and remove them one by one. The time limit was 300 s. The ‘Test Evaluant les Membres supérieurs des Personnes Agées’ (TEMPA) was used to measure the functional performance of the upper limbs [ 22 ]. The four unilateral tasks (“pick up and move a jar”; “pick up a pitcher and pour water into a glass”; “handle coins”; “pick up and move small objects”) were applied [ 23 ].…”

Section: Methodsmentioning

confidence: 99%

Effects of Peripheral Cooling on Upper Limb Tremor Severity and Functional Capacity in Persons with MS

Feys

Duportail²,

Kos

et al. 2023

JCM

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Upper limb intention tremor in persons with multiple sclerosis (pwMS) affects the ability to perform activities of daily life and is difficult to treat. The study investigated the effect of peripheral upper limb cooling on tremor severity and functional performance in MS patients with intention tremor. In experiment 1, 17 patients underwent two 15 min cooling conditions for the forearm (cold pack and cryomanchet) and one control condition. In experiment 2, 22 patients underwent whole arm cooling for 15 min using multiple cold packs. In both experiments, patients were tested at four time points (pre- and post-0, -25 and -50 min cooling) on unilateral tasks of the Test Evaluant les Membres supérieurs des Personnes Agées (TEMPA), Fahn’s tremor rating scale (FTRS), Nine Hole Peg Test (NHPT). In experiment 1, the mean FTRS ranged from 13.2 to 14.1 across conditions. A two-way ANOVA showed mainly time effects, showing that cooling the forearm significantly reduced the FTRS, the performance on the NHPT, and three out of four items of the TEMPA, mostly independent of the cooling modality. In experiment 2, the mean FTRS was 13.1. A repeated measures ANOVA showed that cooling the whole arm reduced the FTRS and time needed to execute two out of four items of the TEMPA. These effects occurred immediately after cooling lasting at least 25 min. Cooling the whole upper limb led to a clinically noticeable effect on tremor severity and improved functional performance, which was pronounced during the first half-hour after cooling.

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Section: Methodsmentioning

confidence: 99%

Effects of Peripheral Cooling on Upper Limb Tremor Severity and Functional Capacity in Persons with MS

Feys

Duportail²,

Kos

et al. 2023

JCM

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“…The inclusion criteria for pwMS were as follows: (1) age between 18 and 60 years; (2) confirmed diagnosis of MS through the McDonald criteria [26], with an evolution time of more than two years; (3) absence of cognitive impairment, with ability to understand instructions and score equal to or greater than 24 on the Minimental Test [25]; (4) score on the Expanded Disability Status Scale (EDSS) between 3.0 and 7.5 [27]; (5) stable medical treatment for at least six months prior to surgery; (6) score less than or equal to 4 points on the "Pyramidal Function" section of the EDSS functional scale; (7) upper extremity muscle tone no greater than 2 points on the modified Ashworth Scale [28]; (8) upper extremity muscle balance equal to or greater than 3 points. The exclusion criteria were as follows: (1) diagnosis of another neurological disease or musculoskeletal disorder other than MS; (2) having suffered an exacerbation or hospitalization in the last 3 months before starting the assessment protocol, nor during the therapeutic intervention process;…”

Section: Ms Subjectsmentioning

confidence: 99%

“…(3) having received a course of intravenous or oral steroids, 6 months before the start of the assessment protocol and within the therapeutic intervention period; (4) presence of visual alterations not corrected by means of ocular devices; (5) use of medications that may influence neuromuscular function (muscle relaxants or analgesics, among others); (6) presence of cerebellar affectation according to medical history or symptomatology suggesting cerebellar affectation, such as the presence of dysdiacokinesias; (7) presence of surgeries on the upper limb in the 6 months prior to the start of the study; and (8) use of caffeine, tea, energy drinks, or supplements during the 24 h before each study visit.…”

Section: Ms Subjectsmentioning

confidence: 99%

“…When cerebellar involvement occurs, dysdiadochokinesia (a common disorder in MS patients) may appear, which is characterized by a limitation or inability to perform rapid and alternating movements. Consequently, this results in a number of functional impairments, which may be combined with cognitive decline, impacting the ability to perform activities of daily living, which, in turn, directly affects the quality of life of people with MS (pwMS) [7][8][9].…”

Section: Introductionmentioning

confidence: 99%

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Reliability and Construct Validity of a Mobile Application for the Finger Tapping Test Evaluation in People with Multiple Sclerosis

Navarro-López,

Cano-de-la-Cuerda,

Fernández-González

et al. 2024

Brain Sciences

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The finger tapping test (FTT) is a tool to evaluate the motor performance of the hand and fingers and eye-hand coordination with applicability in people with multiple sclerosis (pwMS). The aim of this study was to evaluate the intra- and inter-rater reliability of the TappingPro® mobile app and the construct validity between this app and validated clinical scales for motor performance in healthy subjects and pwMS. 42 healthy subjects (mean age 25.05) and 13 pwMS (mean age 51.69, EDSS between 3 and 7.5E) participated. FTT was performed with the TappingPro® mobile app. All participants were examined twice, with a one-week interval between the two appointments. For the analysis of construct validity, the Jamar® hydraulic hand dynamometer, Box and Blocks Test (BBT), and Nine Hole Peg Test (NHPT) were used. The intra-rater reliability showed a good correlation (Intraclass Correlation Coefficient, ICC > 0.787) for both upper limbs and both times of FTT for healthy subjects, and an excellent correlation (ICC > 0.956) for upper limbs and both times of FTT for pwMS. The ICC for the inter-rater reliability was good (ICC = 0.869) for the non-dominant upper limb in the FTT 10 s of the healthy subjects, and excellent (ICC > 0.904) for all the other measurements of the healthy subjects and pwMS. However, the Bland–Altman plots showed disagreement between observers and measurements that should be considered in the interpretation of clinical evaluations. The correlation analysis for healthy subjects showed poor associations between all variables, except for the association between hand grip strength and the FTT 60 s in the non-dominant upper limb, which had a moderate coefficient. For pwMS, there were moderate to excellent associations between BBT and the NHPT and FTT for both upper limbs. The correlations between hand grip strength and FFT were poor. This mobile app could be a useful and low-cost assessment tool in pwMS, allowing a simple evaluation and follow-up that has excellent correlation with clinical scales validated in this pathology.

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“…This issue is present in over 60% of individuals at the time of diagnosis and happens in a greater extent from the beginning of the course of the disease [ 6 ]. Pisa et al [ 7 ] highlight that patients suffering from MS report problems with sensitivity, strength, fine manual dexterity and gross motor skills in the UL. As a result of these impairments, negative effects on employability occur, leading to adverse changes in their economy, health and social life [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

sEMG-controlled forearm bracelet and serious game-based rehabilitation for training manual dexterity in people with multiple sclerosis: a randomised controlled trial

Marcos-Antón,

Jardón-Huete,

Oña-Simbaña

et al. 2023

J NeuroEngineering Rehabil

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Background Muscle strength and dexterity impairments are common among patients with multiple sclerosis (MS) producing limitations in activities of daily living related to the upper limb (UL). This study aimed to evaluate the effectiveness of serious games specifically developed for the MYO Armband® capture sensor in improving forearm and wrist mobility, UL muscle strength, dexterity, fatigue, functionality, quality of life, satisfaction, adverse effects and compliance. Methods A double-blinded (allocation concealment was performed by a blinded investigator and by blinding for assessors) randomised controlled trial was conducted. The sample was randomised into two groups: an experimental group that received treatment based on UL serious games designed by the research team and controlled by the MYO Armband® gesture capture sensor, along with conventional rehabilitation and a control group that received the same conventional rehabilitation for the UL. Both groups received two 60-min sessions per week over an eight-week period. Wrist range of motion (goniometry), grip muscle strength (Jamar® dynamometer), coordination and gross UL dexterity (Box and Block Test), fatigue (Fatigue Severity Scale), functionality (ABILHAND), quality of life (Multiple Sclerosis Impact Scale-29), adverse effects (Simulator Sickness Questionnaire, SSQ), perceived workload (NASA-Task load index), satisfaction (Client Satisfaction Questionnaire-8 (CSQ-8), Satisfaction with Technology Scale, System Usability Scale (SUS) and QUEST 2.0) and compliance (attendance) were assessed in both groups pre-treatment, post-treatment and during a follow-up period of 2 weeks without receiving any treatment. Results Significant differences were observed in the experimental group compared to the control group in the assessment of forearm supination (p = .004) and grip strength (p = .004). Adverse effects were minimal (SSQ: 7/100 points) and perceived workload was low (NASA-Task Load Index: 25/100 points) in the experimental group. The MYO Armband® technology proved to be useful for the participants (SUS: 80.66/100) and the satisfaction scales received high scores (QUEST 2.0: 59.4/70 points; Satisfaction with Technology: 84.36/100 points). There were significant differences between the groups in terms of attendance percentage (p = .029). Conclusions An experimental protocol using MYO Armband®-based serious games designed for UL rehabilitation showed improvements in active wrist range of motion and handgrip strength in patients with MS, with high satisfaction, minimal adverse effects and workload and excellent compliance. Trial registration number: This randomised controlled trial has been registered at ClinicalTrials.gov Identifier: NCT04171908.

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Quantification of upper limb dysfunction in the activities of the daily living in persons with multiple sclerosis

Cited by 8 publications

References 45 publications

Effects of Peripheral Cooling on Upper Limb Tremor Severity and Functional Capacity in Persons with MS

Effects of Peripheral Cooling on Upper Limb Tremor Severity and Functional Capacity in Persons with MS

Reliability and Construct Validity of a Mobile Application for the Finger Tapping Test Evaluation in People with Multiple Sclerosis

sEMG-controlled forearm bracelet and serious game-based rehabilitation for training manual dexterity in people with multiple sclerosis: a randomised controlled trial

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