Measurement of upper limb function in ALS: a structured review of current methods and future directions

Area of Science:

• Neurology
• Biomedical Engineering
• Clinical Trials

Background:

• Upper limb function assessment is crucial for tracking disease progression in amyotrophic lateral sclerosis (ALS).
• The Amyotrophic Lateral Sclerosis Rating Scale-revised (ALSFRS-r) is the standard but suffers from floor and ceiling effects, potentially missing subtle functional changes.
• These limitations impact the evaluation of new ALS therapies and treatments.

Purpose of the Study:

• To conduct a structured review of current and emerging technologies for measuring upper limb function in ALS.
• To explore the potential of technology to provide sensitive and objective outcome measures.
• To identify limitations of current technological solutions and unmet needs in ALS upper limb assessment.

Main Methods:

• A structured review of scientific literature on upper limb function measurement in ALS.
• Analysis of current technological sensors and solutions for objective outcome measurement.
• Discussion of future trends and potential technological advancements.

Main Results:

• The ALSFRS-r scale has significant limitations in capturing clinically meaningful changes in upper limb function.
• Technology offers promising avenues for more sensitive and objective upper limb assessments in ALS.
• Current technological solutions face challenges related to cost and user suitability.

Conclusions:

• There is an ongoing need for simple, sensitive, and clinically relevant tests for upper limb function in ALS.
• Technological advancements are poised to revolutionize upper limb measurement in ALS.
• Consensus is needed on the future direction of technology to meet the unmet needs in ALS research and clinical practice.