Trunk control: The essence for upper limb functionality in patients with multiple sclerosis.

Area of Science:

• Neuroscience
• Rehabilitation Medicine
• Clinical Neurology

Background:

• Multiple sclerosis (MS) frequently impairs trunk control, impacting upper-limb function, dexterity, and independence.
• Early, individualized assessment is crucial for multimodal treatment programs in MS.
• Trunk postural control is considered vital for upper-limb motor control and dexterity.

Purpose of the Study:

• To investigate trunk control impairments in individuals with MS.
• To determine the relationship between trunk control and upper-limb functionality in MS patients.
• To compare the efficacy of different clinical tests for assessing these functions.

Main Methods:

• Compared 49 relapsing-remitting MS (RRMS) participants with 49 healthy controls.
• Utilized Trunk Control Test (TCT) and Trunk Impairment Scale (TIS) for trunk control.
• Assessed upper-limb function using the Expanded Disability Status Scale (EDSS), Nine Hole Peg Test (NHPT), Duruoz's Hand Index (DHI), and Functional Independence Measurement (FIM).

Main Results:

• Significant differences (p < 0.05) were observed between MS patients and controls across most tests, except TCT-balance in sitting.
• EDSS, NHPT, DHI, and FIM scores strongly correlated with TCT and TIS scores (p ≤ 0.005).
• TIS subscores showed high correlation with most parameters, with TIS-static not correlating with DHI and FIM-cognitive scores.

Conclusions:

• MS patients, including those with mild RRMS, demonstrate correlated impairments in upper-limb movement and trunk control.
• Identifying trunk control deficits offers insights into upper-limb dexterity issues and guides targeted neurorehabilitation.
• Future longitudinal studies should explore the prognostic value of trunk control and upper-limb function in MS.