Development of novel biomechanical outcomes using motion capture to characterize hand function in multiple sclerosis

Area of Science:

• Neurology
• Biomedical Engineering
• Rehabilitation Science

Background:

• The Nine-Hole Peg Test (9HPT) has limitations in assessing upper extremity function in people with Multiple Sclerosis (PwMS).
• Existing measures may be insensitive to subtle impairments in PwMS.

Purpose of the Study:

• Develop novel biomechanical outcomes to better characterize upper extremity function in PwMS.
• Identify new quantitative measures sensitive to MS-related motor deficits.

Main Methods:

• 16 PwMS and 16 healthy controls (HC) performed an iPad-based manual dexterity test (MDT).
• A Kinect® device captured 3D hand motion, analyzed using a mathematical model to derive novel outcomes.
• Associations between MDT outcomes and clinical measures (spasticity, dysmetria, weakness) were assessed.

Main Results:

• Novel measures like 'Time to Grab' showed large effect sizes in discriminating PwMS from HC for both dominant and non-dominant hands.
• Several other novel measures, including 'Actual Distance-xy' and 'Movement Delay', also demonstrated significant effect sizes.
• The traditional MDT total time also showed a large effect size for the non-dominant hand.

Conclusions:

• MDT Total Time remains a valuable conventional measure for discriminating PwMS from HC.
• Novel biomechanical measures derived from the MDT show potential for enhanced characterization of PwMS' upper extremity function.
• These new measures correlate with clinical characteristics, offering a more comprehensive assessment than traditional methods.