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Association between cognitive dysfunction and upper extremity performance in multiple sclerosis: a cross-sectional
Aybike Erkoç1, Nezehat Özgül Ünlüer2
1Gülhane Institute of Health Sciences, University of Health Sciences, Ankara, Türkiye. aybikeerkoc@gmail.com.
Background:
Multiple sclerosis (MS) is a demyelinating disease that affects cognitive function and upper extremity performance.
Aim:
To investigate cognitive impairment and upper extremity performance in individuals with MS and to compare these parameters with those of healthy controls.
Methods:
The study included 32 individuals with MS and 30 healthy controls. Participants were assessed using the Loewenstein Occupational Therapy Cognitive Assessment (LOTCA), Nine-Hole Peg Test, Upper Extremity Y Balance Test, Jamar® Hand Dynamometer, Ruler-Drop Reaction Time Test, Upper Extremity Functional Index-20 (UEFI-20), Modified Push-up Test, and Touching Discs Test.
Results:
Compared with the control group, individuals with MS demonstrated lower scores in spatial perception (Z = 3.162, p = 0.002, r = 0.40), motor praxis (Z = 2.085, p = 0.037, r = 0.26), visual-motor organization (Z = 4.827, p < 0.001, r = 0.61), thinking skills (Z = 4.300, p < 0.001, r = 0.55), attention parameters (Z = 4.550, p < 0.001, r = 0.53), and total LOTCA scores (Z = 4.796, p < 0.001, r = 0.61,). In individuals with MS, spatial perception was associated with upper extremity endurance (rho = 0.350, p = 0.049), dominant upper extremity coordination (rho = 0.469, p = 0.007), non-dominant upper extremity coordination (rho = 0.463, p = 0.008), and dominant upper extremity fine motor skills (rho = 0.361, p = 0.042). Visual-motor organization was associated with upper extremity endurance (rho = 0.598, p < 0.001), dominant upper extremity coordination (rho = 0.402, p = 0.023), dominant reaction time (rho = 0.385, p = 0.029), non-dominant reaction time (rho = 0.523, p = 0.002), and selected upper extremity balance parameters (p < 0.05). Attention was related to upper extremity endurance (rho = 0.355, p = 0.046), dominant grip strength (rho = 0.365, p = 0.040), and non-dominant grip strength (rho = 0.393, p = 0.027). Total LOTCA scores were associated with upper extremity endurance (rho = 0.036, p = 0.846).
Conclusion:
Cognitive and upper extremity impairments coexist in MS, emphasizing cognitive assessment in rehabilitation.
