Upper Limb Dexterity in Patients with Multiple Sclerosis: An Important and Underrated Morbidity

Scales to assess disability in multiple sclerosis (MS) rarely provide reliable data on actual global impairment. Upper limb dysfunction is usually overlooked, which has a negative effect on patient well-being. We sought to analyze associations among upper limb dexterity, lower limb speed, and Expanded Disability Status Scale (EDSS) score; the difference in upper limb dexterity between patients with EDSS scores less than 5 and 5 or greater; and the associations that upper limb dexterity, lower limb speed, and EDSS score have with health-related quality of life measurements and depression.

A total of 140 adults with MS were evaluated using the Nine-Hole Peg Test, Timed 25-Foot Walk test, EDSS, Multiple Sclerosis International Quality of Life (MusiQoL) questionnaire, and Beck Depression Inventory. Thorough descriptive-analytical research was conducted using the Spearman correlation, multiple linear regression, and structural equation modeling.

Upper limb dexterity was more closely related to EDSS score than lower limb speed (r = 0.43 vs 0.29, R ² = 0.38) and was greatest in patients with EDSS scores less than 5 (P < .01). Moreover, upper limb dexterity was negatively associated with EDSS score and the MusiQoL questionnaire (r = -0.557 to -0.321, P < .05). The correlation that depression has with upper limb dexterity loss was higher than the one it has with lower limb speed (0.098 vs 0.066, t > 1.96).

Upper limb dexterity is associated with global disability, depression, and health-related quality of life. We advocate for the assessment of upper limb dexterity in patients with MS to adopt a better approach to their functional impairment.