Abstract
Impaired dexterity is a frequently reported disability among people with ataxic multiple sclerosis (MS). To quantify and standardize the evaluation of upper extremity coordination disorder among patients with multiple sclerosis (MS), using the Tablet Ataxia Assessment Program (TAAP). The X and Y axis movements of 50 MS patients and 30 healthy individuals who were evaluated using the International Cooperative Ataxia Rating Scale (ICARS) were also assessed using TAAP. The functional times of the participants' right and left hands were recorded using the nine-hole peg test (NHPT). The upper extremity coordination of individuals with MS was evaluated using the upper extremity kinetic functions section of ICARS. The deviations for the X and Y axis movements of the MS group were greater than those of the control group (p<0.05). Significant correlations were shown between TAAP scores and NHPT and ICARS scores. The strongest correlation was found between NHPT and ICARS in the dominant hand (rnhpt=0.356, pnhpt=0.001; ricars=0.439, picars=0.000). In correlating the Y axis with ICARS, the deviations in the Y axis were found to be greater in the non-dominant hand than those in the X axis (ryright=0.402, pyright=0.004; ryleft=0.691, pyleft=0.000). Measurement using TAAP is more sensitive than other classical and current methods for evaluating ataxia. We think that TAAP is an objective tool that will allow neurorehabilitation professionals and clinicians to evaluate upper extremity coordination.
Highlights
Ataxia is defined as a disorder in the coordination of voluntary muscle movement
Comparison of the mean nine-hole peg test (NHPT), Tablet Ataxia Assessment Program (TAAP) and International Cooperative Ataxia Rating Scale (ICARS) scores of the right and left hands of the healthy individuals and multiple sclerosis (MS) patients with extremity ataxia showed that the differences between the groups were significant (p
The usability of the TAAP was examined through correlating the X horizontal and Y vertical data obtained from patients with ataxic MS, in order to quantify and standardize functional changes in upper extremity movements, using TAAP (Table 3)
Summary
Ataxia is defined as a disorder in the coordination of voluntary muscle movement. It is not a disease but, rather, a physical finding[1] and is seen in approximately 75% of patients with multiple sclerosis (MS)[2]. In addition to surgical and pharmacological treatments, physiotherapy modalities such as exercise, thermal applications and electrotherapy are widely used to cope with ataxic symptoms Various scales such as the International Cooperative Ataxia Rating Scale (ICARS)[4] and the Ataxia Assessment and Rating Scale (SARA)[5] are used to detect ataxia in MS patients and to verify the effectiveness of treatments. These assessment methods consist of sub-parameters evaluating posture, gait, speech and upper extremity performance. The aim of our observational, cross-sectional study was to evaluate upper extremity ataxia in MS patients using TAAP, which is an objective assessment method. Upper extremity ataxia was investigated using a sensor mounted on the patient’s index finger, and kinematic information was evaluated through a program loaded on the tablet
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