Unilateral and bilateral upper limb dysfunction at body functions, activity and participation levels in people with multiple sclerosis

Rita Bertoni, Ilse Lamers, Christine C. Chen, Peter Feys, Davide Cattaneo

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

Background: There has been limited research on upper limb dysfunction in people with multiple sclerosis (PwMS). Objective: The objective of this paper is to study unilateral and bilateral upper limb dysfunction at different International Classification of Functioning (ICF) levels according to overall disability in PwMS. Methods: A total of 105 PwMS (16 with EDSS<4 (mild); 17 with EDSS 4-5.5 (moderate); 37 with EDSS 6-6.5 (severe); 35 with EDSS>6.5 (severe non-ambulant)) were recruited from two rehabilitation centers and assessed in a cross-sectional study. Results: The whole sample showed a diminished sensory function (median (first/third interquartile)) score of 3 (2/3) on the Monofilament Test and a reduced strength 91 (76/100) points on the Motricity Index (Body-Function level). Sensory dysfunction did not increase with higher EDSS while strength decreased from 100 (86/100) in the mild subgroups to 91 (80/100) points in the severe subgroup. All showed diminished dexterity, scoring 0.28 peg/s (0.17/0.35) on the Nine-Hole Peg Test (NHPT) (activity level). Score was better for the mild (0.38 (0.35/0.46)) peg/s compared to the severe subgroup (0.28 (0.17/0.35)). Sixtyeight percent, 44% and 75% of PwMS showed bilateral disorders in sensation, strength and dexterity, respectively. The Community Integration Questionnaire (participation level) showed a 35% reduction in home activities, even among PwMS with EDSS<4. Conclusion: This study showed uni-/bilateral upper limb abnormalities at all ICF levels increasing with the overall disability.

Original languageEnglish
Pages (from-to)1566-1574
Number of pages9
JournalMultiple Sclerosis Journal
Volume21
Issue number12
DOIs
Publication statusPublished - 2015

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Upper Extremity
Multiple Sclerosis
Community Integration
Sensation Disorders
Rehabilitation Centers
Disabled Persons
Cross-Sectional Studies
Research

Keywords

  • Bilateral involvement
  • Dysfunction
  • ICF
  • Multiple sclerosis
  • Upper limb

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

Cite this

Unilateral and bilateral upper limb dysfunction at body functions, activity and participation levels in people with multiple sclerosis. / Bertoni, Rita; Lamers, Ilse; Chen, Christine C.; Feys, Peter; Cattaneo, Davide.

In: Multiple Sclerosis Journal, Vol. 21, No. 12, 2015, p. 1566-1574.

Research output: Contribution to journalArticle

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title = "Unilateral and bilateral upper limb dysfunction at body functions, activity and participation levels in people with multiple sclerosis",
abstract = "Background: There has been limited research on upper limb dysfunction in people with multiple sclerosis (PwMS). Objective: The objective of this paper is to study unilateral and bilateral upper limb dysfunction at different International Classification of Functioning (ICF) levels according to overall disability in PwMS. Methods: A total of 105 PwMS (16 with EDSS<4 (mild); 17 with EDSS 4-5.5 (moderate); 37 with EDSS 6-6.5 (severe); 35 with EDSS>6.5 (severe non-ambulant)) were recruited from two rehabilitation centers and assessed in a cross-sectional study. Results: The whole sample showed a diminished sensory function (median (first/third interquartile)) score of 3 (2/3) on the Monofilament Test and a reduced strength 91 (76/100) points on the Motricity Index (Body-Function level). Sensory dysfunction did not increase with higher EDSS while strength decreased from 100 (86/100) in the mild subgroups to 91 (80/100) points in the severe subgroup. All showed diminished dexterity, scoring 0.28 peg/s (0.17/0.35) on the Nine-Hole Peg Test (NHPT) (activity level). Score was better for the mild (0.38 (0.35/0.46)) peg/s compared to the severe subgroup (0.28 (0.17/0.35)). Sixtyeight percent, 44{\%} and 75{\%} of PwMS showed bilateral disorders in sensation, strength and dexterity, respectively. The Community Integration Questionnaire (participation level) showed a 35{\%} reduction in home activities, even among PwMS with EDSS<4. Conclusion: This study showed uni-/bilateral upper limb abnormalities at all ICF levels increasing with the overall disability.",
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