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Published on: March 4, 2014
Upper limb dysfunction in people with early-stage Multiple Sclerosis: Perceived performance can be misleading.
Ugur Ovacik1, Ela Tarakci2, Zeynep Ozdemir3
1Physiotherapy Program, Department of Medical Services and Techniques, Vocational School of Health Services, Istanbul Aydin University, Istanbul, Turkey; Department of Physiotherapy and Rehabilitation, Institute of Graduate Studies, Istanbul University-Cerrahpasa, Istanbul, Turkey.
Early-stage Multiple Sclerosis patients show upper limb dysfunction despite not reporting daily living issues. Objective assessments reveal deficits, highlighting the need for early intervention in MS care.
Area of Science:
- Neurology
- Rehabilitation Science
Background:
- Upper limb (UL) dysfunction assessment is crucial for people with Multiple Sclerosis (pwMS), yet often neglected in early stages.
- Early-stage pwMS may be unaware of subtle UL involvement impacting their daily lives.
Purpose of the Study:
- To comprehensively evaluate bilateral UL function in early-stage pwMS with minimal reported daily living limitations.
- To compare UL function between early-stage pwMS and healthy controls (HC).
- To explore relationships between UL function and various clinical/patient-reported factors.
Main Methods:
- Bilateral UL muscle strength, sensation, and dexterity were assessed in 44 early-stage pwMS (EDSS<4, disease duration<5 years) and 44 HC.
- Evaluated relationships between UL function and muscle strength, sensation, cognition, fatigue, mood, participation, EDSS, and disease duration.
- Analyzed objective and subjective outcome measures of UL function.
Main Results:
- UL muscle strength, sensation, and dexterity were significantly affected in early-stage pwMS compared to HC.
- A notable percentage of pwMS showed objective UL impairment on the Nine Hole Peg Test.
- Patient-reported outcome measures like ABILHAND may overestimate function due to ceiling effects in early disease stages.
Conclusions:
- Objective UL functional capacity is impaired in early-stage pwMS, even before significant impact on daily activities.
- Patient-reported outcomes can be misleading in early MS; objective assessments are vital.
- Clinicians and researchers should prioritize early UL function evaluation and integrate it into treatment plans for pwMS to mitigate long-term disability.
