Upper extremity function in multiple sclerosis: improving assessment sensitivity with box-and-block and nine-hole peg...

Area of Science:

• Neurology
• Clinical Trials
• Rehabilitation Medicine

Background:

• Multiple Sclerosis (MS) patient management requires sensitive functional assessments.
• Current assessments may not adequately capture upper extremity changes in MS.
• Standardized definitions are needed for clinical trial efficacy evaluation.

Purpose of the Study:

• To evaluate the utility of the nine-hole peg test (9HPT) and box-and-block test (BBT) for assessing upper extremity function in MS patients.
• To compare the sensitivity of 9HPT and BBT against the Kurtzke Expanded Disability Status Scale (EDSS).

Main Methods:

• Prospective study of MS patients over six months.
• Utilized the nine-hole peg test (9HPT) and box-and-block test (BBT) for upper extremity assessment.
• Compared functional changes with Kurtzke Expanded Disability Status Scale (EDSS) scores.

Main Results:

• Upper extremity dysfunction is more prevalent in MS than previously recognized, as indicated by 9HPT and BBT.
• Patients reported subjective functional changes not reflected in EDSS scores.
• The 9HPT and BBT demonstrated higher sensitivity to functional status changes compared to EDSS.

Conclusions:

• The nine-hole peg test and box-and-block test are sensitive and reproducible measures for upper extremity function in MS.
• These tests are valuable tools for monitoring patients in multiple sclerosis clinical trials.
• Implementing 9HPT and BBT can enhance the detection of treatment effects on function.