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A novel tool for characterising upper limb function in progressive multiple sclerosis through kinematic assessment.

Linford Fernandes1, Rachel O Coats2, Mark Mon-Williams2

  • 1Leeds Teaching Hospitals NHS Trust, Centre for Neurosciences, UK.

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|June 8, 2024
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Summary

A novel kinematic assessment tool reveals subtle upper limb function changes in progressive multiple sclerosis (MS) that traditional tests miss. This technology offers a more sensitive measure for tracking disease progression and treatment effectiveness in people with MS.

Keywords:
KinematicsPatient reported outcome measuresPrehensionUpper limb function

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Area of Science:

  • Neurology
  • Biomedical Engineering
  • Rehabilitation Science

Background:

  • Current assessments for upper limb function in multiple sclerosis (MS) primarily use duration-based tasks like the nine-hole peg test (9HPT).
  • Kinematic techniques offer a potential for more sensitive and detailed measurement of functional changes in MS.
  • This study aimed to prospectively evaluate upper limb function in progressive MS using 3D motion capture and compare it with existing measures.

Purpose of the Study:

  • To assess upper limb function prospectively in people with progressive MS (PwPMS).
  • To compare kinematic assessment data with traditional measures like the nine-hole peg test (9HPT) and the Expanded Disability Status Scale (EDSS).
  • To identify subtle hand function changes not detectable by current standard assessments.

Main Methods:

  • 42 people with progressive MS (PwPMS) and 15 healthy controls performed reach-and-grasp tasks.
  • A kinematic 3D motion capture system recorded movement data.
  • Data collected included 9HPT, EDSS, and patient-reported outcomes (PROs) at baseline and six-month follow-up for PwPMS.

Main Results:

  • PwPMS exhibited significantly longer reaction, reach, and object manipulation times compared to controls.
  • Lower peak velocities during reaching and moving were observed in PwPMS.
  • Kinematic assessment identified differences in upper limb dysfunction severity (based on PROs) not captured by 9HPT or EDSS, and detected altered grip aperture profiles over time.

Conclusions:

  • A novel kinematic upper limb assessment tool was developed and validated.
  • This tool detects specific hand function changes and characteristics in PwPMS that are missed by the EDSS and 9HPT.
  • The kinematic system provides a more sensitive method for evaluating upper limb function in progressive MS.