Participation Restriction in People With Multiple Sclerosis: Prevalence and Correlations With Cognitive, Walking, Balance, and Upper Limb Impairments

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Abstract

Objectives: To calculate the percentage of participation restrictions according to disability level in multiple sclerosis (MS), and to assess the relationship between participation restrictions and cognitive, gait, balance, and upper limb deficits. Design: Cross-sectional study. Setting: Rehabilitation unit. Participants: Participants (N=125) consisted of people with MS (n=105) and healthy subjects (HS; n=20). Interventions: Not applicable. Main Outcome Measures: The Community integration Questionnaire was used to assess participation in home, social, and productive activities. Percentages of people with MS having Community Integration Questionnaire scores lower than the 10th percentile of those of HS were calculated for each subscale to categorize the persons with participation restrictions. Cognitive deficits (Symbol Digit Modalities Test), walking disability (25-ft walking test/Expanded Disability Status Scale [EDSS)), balance disorders (Bohannon Standing Balance Test), and manual dexterity (Nine Hole Peg Test) were recorded. Results: Seventy-seven percent of participants showed participation restrictions, which increased with higher EDSS scores from 40% (EDSS<4) to 82% (EDSS>5.5). Social participation was more restricted than home integration, with <20% of participants shopping for groceries alone. Cognitive deficits were more highly associated (r=.60) with participation restrictions than balance (r=.47), gait (r=-.45), and hand dexterity (r=.45) limitations. Conclusions: Participation restrictions are present in MS and increase with disability level. However, the results also show that MS does not restrict participation in all domains. Participation restrictions at home are less restricted compared with social participation. Cognitive disorders are more associated with participation restrictions than physical limitations.

Original languageEnglish
JournalArchives of Physical Medicine and Rehabilitation
DOIs
Publication statusE-pub ahead of print - Mar 2017

Fingerprint

Upper Extremity
Multiple Sclerosis
Walking
Community Integration
Social Participation
Gait
Healthy Volunteers
Rehabilitation
Hand
Cross-Sectional Studies
Outcome Assessment (Health Care)
Surveys and Questionnaires

Keywords

  • Cognition
  • Community participation
  • Gait
  • Posture
  • Rehabilitation
  • Upper extremity

ASJC Scopus subject areas

  • Physical Therapy, Sports Therapy and Rehabilitation
  • Rehabilitation

Cite this

@article{0a0bc43e18434751967fede4c14bf6ba,
title = "Participation Restriction in People With Multiple Sclerosis: Prevalence and Correlations With Cognitive, Walking, Balance, and Upper Limb Impairments",
abstract = "Objectives: To calculate the percentage of participation restrictions according to disability level in multiple sclerosis (MS), and to assess the relationship between participation restrictions and cognitive, gait, balance, and upper limb deficits. Design: Cross-sectional study. Setting: Rehabilitation unit. Participants: Participants (N=125) consisted of people with MS (n=105) and healthy subjects (HS; n=20). Interventions: Not applicable. Main Outcome Measures: The Community integration Questionnaire was used to assess participation in home, social, and productive activities. Percentages of people with MS having Community Integration Questionnaire scores lower than the 10th percentile of those of HS were calculated for each subscale to categorize the persons with participation restrictions. Cognitive deficits (Symbol Digit Modalities Test), walking disability (25-ft walking test/Expanded Disability Status Scale [EDSS)), balance disorders (Bohannon Standing Balance Test), and manual dexterity (Nine Hole Peg Test) were recorded. Results: Seventy-seven percent of participants showed participation restrictions, which increased with higher EDSS scores from 40{\%} (EDSS<4) to 82{\%} (EDSS>5.5). Social participation was more restricted than home integration, with <20{\%} of participants shopping for groceries alone. Cognitive deficits were more highly associated (r=.60) with participation restrictions than balance (r=.47), gait (r=-.45), and hand dexterity (r=.45) limitations. Conclusions: Participation restrictions are present in MS and increase with disability level. However, the results also show that MS does not restrict participation in all domains. Participation restrictions at home are less restricted compared with social participation. Cognitive disorders are more associated with participation restrictions than physical limitations.",
keywords = "Cognition, Community participation, Gait, Posture, Rehabilitation, Upper extremity",
author = "Davide Cattaneo and Ilse Lamers and Rita Bertoni and Peter Feys and Johanna Jonsdottir",
year = "2017",
month = "3",
doi = "10.1016/j.apmr.2017.02.015",
language = "English",
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TY - JOUR

T1 - Participation Restriction in People With Multiple Sclerosis

T2 - Prevalence and Correlations With Cognitive, Walking, Balance, and Upper Limb Impairments

AU - Cattaneo, Davide

AU - Lamers, Ilse

AU - Bertoni, Rita

AU - Feys, Peter

AU - Jonsdottir, Johanna

PY - 2017/3

Y1 - 2017/3

N2 - Objectives: To calculate the percentage of participation restrictions according to disability level in multiple sclerosis (MS), and to assess the relationship between participation restrictions and cognitive, gait, balance, and upper limb deficits. Design: Cross-sectional study. Setting: Rehabilitation unit. Participants: Participants (N=125) consisted of people with MS (n=105) and healthy subjects (HS; n=20). Interventions: Not applicable. Main Outcome Measures: The Community integration Questionnaire was used to assess participation in home, social, and productive activities. Percentages of people with MS having Community Integration Questionnaire scores lower than the 10th percentile of those of HS were calculated for each subscale to categorize the persons with participation restrictions. Cognitive deficits (Symbol Digit Modalities Test), walking disability (25-ft walking test/Expanded Disability Status Scale [EDSS)), balance disorders (Bohannon Standing Balance Test), and manual dexterity (Nine Hole Peg Test) were recorded. Results: Seventy-seven percent of participants showed participation restrictions, which increased with higher EDSS scores from 40% (EDSS<4) to 82% (EDSS>5.5). Social participation was more restricted than home integration, with <20% of participants shopping for groceries alone. Cognitive deficits were more highly associated (r=.60) with participation restrictions than balance (r=.47), gait (r=-.45), and hand dexterity (r=.45) limitations. Conclusions: Participation restrictions are present in MS and increase with disability level. However, the results also show that MS does not restrict participation in all domains. Participation restrictions at home are less restricted compared with social participation. Cognitive disorders are more associated with participation restrictions than physical limitations.

AB - Objectives: To calculate the percentage of participation restrictions according to disability level in multiple sclerosis (MS), and to assess the relationship between participation restrictions and cognitive, gait, balance, and upper limb deficits. Design: Cross-sectional study. Setting: Rehabilitation unit. Participants: Participants (N=125) consisted of people with MS (n=105) and healthy subjects (HS; n=20). Interventions: Not applicable. Main Outcome Measures: The Community integration Questionnaire was used to assess participation in home, social, and productive activities. Percentages of people with MS having Community Integration Questionnaire scores lower than the 10th percentile of those of HS were calculated for each subscale to categorize the persons with participation restrictions. Cognitive deficits (Symbol Digit Modalities Test), walking disability (25-ft walking test/Expanded Disability Status Scale [EDSS)), balance disorders (Bohannon Standing Balance Test), and manual dexterity (Nine Hole Peg Test) were recorded. Results: Seventy-seven percent of participants showed participation restrictions, which increased with higher EDSS scores from 40% (EDSS<4) to 82% (EDSS>5.5). Social participation was more restricted than home integration, with <20% of participants shopping for groceries alone. Cognitive deficits were more highly associated (r=.60) with participation restrictions than balance (r=.47), gait (r=-.45), and hand dexterity (r=.45) limitations. Conclusions: Participation restrictions are present in MS and increase with disability level. However, the results also show that MS does not restrict participation in all domains. Participation restrictions at home are less restricted compared with social participation. Cognitive disorders are more associated with participation restrictions than physical limitations.

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KW - Gait

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KW - Rehabilitation

KW - Upper extremity

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