Abstract
Background Activities of daily living and quality of life (QOL) are hindered by upper extremity (UE) impairments experienced by individuals with multiple sclerosis (iMS). The Nine-Hole Peg Test (9-HPT) is most frequently used to measure UE function. However, it does not measure peoples' ability to perform routine tasks in daily life and may not be useful in iMS who cannot pick up the pegs utilized in the 9-HPT. Therefore, we evaluated three measures to explore a more comprehensive assessment of UE function: Upper Extremity Function Scale (UEFS), Action Research Arm Test (ARAT), and the 9-HPT. The objectives were to quantitatively assess the relationship between these measures of UE function, understand if the measures correlate with QOL as calculated by the MS Quality of Life-54 (MSQOL-54), and to determine differences in the measures based on employment status. Methods 112 (79 female) iMS were prospectively recruited for this descriptive correlational study. Inclusion criteria were as follows: confirmed diagnosis of MS or clinically isolated syndrome, age ≥ 18 years, and ability to self-consent. All statistical analyses including Spearman's correlation coefficient (rs) and Kruskal-Wallis tests were performed using SPSS. Results A moderate correlation (rs = −0.51; p < 0.001) was found between the ARAT and 9-HPT scores for the more impaired hand. Likewise, a moderate correlation was found between UEFS and the physical health composite scores (PHCSs) of MSQOL-54 (rs = −0.59; p < 0.001). Finally, performances on ARAT, 9-HPT, and UEFS differed between the employed individuals and those on long-term disability (p = 0.007, p < 0.001, and p = 0.001). Conclusion The UEFS moderately correlated with the QOL measure, and considering the UESF is a patient-reported outcome, it could be used to complement routinely captured measures of assessing UE function. Further study is warranted to determine which measure, or combination of measures, is more sensitive to changes in UE function over time.
Highlights
Upper extremity (UE) impairment, caused by a combination of motor and sensory deficits, hinders the ability of individuals with multiple sclerosis to perform activities of daily living (ADL) and decreases their quality of life (QOL) [1]
On the basis of these considerations, the objectives of the present study were as follows: (1) to quantitatively assess the relationship between measures of assessing upper extremity (UE) function (UEFS, Action Research Arm Test (ARAT), and 9-HPT), (2) to understand if the performances on these three measures of assessing UE function correlate with QOL as measured by the Multiple Sclerosis (MS) Quality of Life-54 (MSQOL-54), and (3) to determine differences in the scores obtained from these measures of assessing UE function based on employment status
Patient Characteristics and Scores Obtained from Study Measures. 112 individuals with multiple sclerosis (iMS) (79 female and 33 male mean age 50:3 ± 12:5 years; mean duration of MS 17:1 ± 14:1 years; 71 relapsing-remitting multiple sclerosis (RRMS), 23 secondary progressive multiple sclerosis (SPMS), 15 primary progressive multiple sclerosis (PPMS), and 3 clinically isolated syndrome (CIS)) were included in this study
Summary
Upper extremity (UE) impairment, caused by a combination of motor and sensory deficits, hinders the ability of individuals with multiple sclerosis (iMS) to perform activities of daily living (ADL) and decreases their quality of life (QOL) [1]. The multitude of tests available, the increased use of PROM for patient assessment, and the limitations in the 9-HPT bring to question if a more comprehensive measure of assessing UE function, such as the ARAT and UEFS, would better correlate to QOL in iMS. On the basis of these considerations, the objectives of the present study were as follows: (1) to quantitatively assess the relationship between measures of assessing UE function (UEFS, ARAT, and 9-HPT), (2) to understand if the performances on these three measures of assessing UE function correlate with QOL as measured by the Multiple Sclerosis (MS) Quality of Life-54 (MSQOL-54), and (3) to determine differences in the scores obtained from these measures of assessing UE function based on employment status. Further study is warranted to determine which measure, or combination of measures, is more sensitive to changes in UE function over time
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