Abstract
Background In people with multiple sclerosis (pwMS), disability is generally assessed on the basis of ambulation abilities, whereas upper limb motor dysfunctions are less frequently considered. Nevertheless, they can severely affect the quality of life of pwMS. To date, it remains mostly unknown whether a relationship exists between upper and lower limb impairments. Aim To investigate the existence of a relationship between upper and lower limb impairments in pwMS based on two fundamental motor tasks, namely walking and hand-to-mouth (HTM) movement. Methods Twenty-eight pwMS with Expanded Disability Status Scale (EDSS) scores in the range of 1–6, and 21 healthy controls (HC) underwent a kinematic analysis of gait and HTM movement performed with a motion capture system. The spatiotemporal parameters for the two tasks were calculated and correlated using Spearman's rank correlation coefficients. Results The pwMS performed worse than HC on both tasks. Small to large correlations were found between the total HTM movement duration and most of the gait parameters (rho, 0.35–0.68; p < 0.05). Conclusions Both upper and lower limb motor abilities in pwMS worsen as disability increases. Nevertheless, their relationship is only moderate. This finding emphasizes the need for specific tests to quantify disability considering the overall motor function in pwMS.
Highlights
In people with multiple sclerosis, motor dysfunctions like ataxia, spasticity, incoordination, and sensory disturbances can affect the functionality of both lower and upper limbs. In the former case, they are likely to be responsible for walking abnormalities, usually expressed in the form of increased double support time and reduced gait speed, step length, and cadence [1], which are very common in pwMS even in the early stages of the disease [2]
It is noteworthy that the most frequently used clinical tool to assess the level of disability in MS is essentially based on walking abilities, with the underlying assumption being that they are the main factor affected by the disease [9, 10]
While this approach is certainly justified by the higher frequency and severity of lower limb dysfunction in pwMS since longer neural pathways are more likely to be involved in central nervous system damage, according to this framework upper limb impairment is neglected or, at the very least, is implicitly considered to have a similar impact as walking impairments on overall disability
Summary
In people with multiple sclerosis (pwMS), disability is generally assessed on the basis of ambulation abilities, whereas upper limb motor dysfunctions are less frequently considered. They can severely affect the quality of life of pwMS. Aim. To investigate the existence of a relationship between upper and lower limb impairments in pwMS based on two fundamental motor tasks, namely walking and hand-to-mouth (HTM) movement. Both upper and lower limb motor abilities in pwMS worsen as disability increases. Their relationship is only moderate. is finding emphasizes the need for specific tests to quantify disability considering the overall motor function in pwMS
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