Manual Dexterity Test Research Articles

Characterizing Hand Function in Parkinson's Disease Patients with a Self-Administered Electronic Manual Dexterity Test.

Dexterous dysfunction is a bothersome patient-reported symptom of Parkinson's disease (PD). Current clinical assessments do not directly evaluate goal-directed hand function. This project sought to determine the capability of the electronic Manual Dexterity Test (MDT) to characterize dexterity across a range of PD patients. To objectively quantify manual dexterity in individuals with PD using a self-administered manual dexterity test. Two hundred and forty-nine PD patients completed trials of the MDT with each upper extremity (UE) both while ON and OFF antiparkinsonian medication. Differences in MDT by medication state, more vs less affected UE, and Hoehn and Yahr (H&Y) stage were evaluated using linear mixed models. The relationships of trial duration to MDS-UPDRS II patient quality of life (QoL) questions for eating, dressing and hygiene were also evaluated. MDT duration was significantly shorter ON medication (26.3 seconds) compared to OFF medication (27.2 seconds) (P < 0.001). Similarly, MDT duration was significantly shorter for less (25.8 seconds) compared to more (27.6 seconds) affected limb (P < 0.001). Trial durations increased with H&Y stage (P < 0.001 for trend). MDT performance was related to MDS-UPDRS II questions for eating, dressing, and hygiene performance (P < 0.001). The MDT provides an objective and quantitative assessment of dexterity. The time to complete the MDT was sensitive to changes in medication state, more and less affected UE, disease severity, and important activities of daily living. The MDT has potential for utilization in precise tracking of manual dexterity over the course of PD.

G.T.A.R.A. (Grip/Grasp Training with Active Range of Motion Activities Using Guitar): A Randomized Controlled Trial Using Guitar Lessons for Restoring Hand Function among Patients with Unilateral Hand Impairment

Objective. To determine the effects of guitar lessons (intervention group) in comparison to conventional occupational therapy (OT) sessions (control group) on hand function of chronic stroke patients with unilateral hand impairment. Methods. This randomized controlled trial enrolled 34 chronic stroke patients with unilateral hand impairment. Participants were grouped randomly into intervention (guitar lessons) and control (conventional occupational therapy) groups. Each group participant underwent a total of eight consecutive therapy sessions, twice weekly for an hour each session, at the designated treatment rooms in the Department of Rehabilitation Medicine of the Philippine General Hospital. Pre- and post-treatment evaluations were done to assess range of motion, grip and pinch strength, and hand functions. Satisfaction surveys were answered at the end of the 8-therapy session. Results. Improvements in hand function were assessed through measurement of range of motion (ROM), grip and pinch strength, and with the use of Beery-Buktenica Developmental Test of Visual-Motor Integration, Jebsen-Taylor Hand Function test, and Purdue Pegboard Test of Manual Dexterity. In this study, the comparison of actual change of passive range of motion (ROM) of the impaired hand from pre- to post-treatment between control and intervention groups showed no statistically significant difference. No statistically significant difference between groups were also observed for the active ROM of the impaired hand. Comparison of function of the impaired hand pre- and posttreatment between control and intervention groups showed no statistically significant difference except for an observed greater improvement with the control group in motor coordination (median [IQR] 0 [-1 to 0] vs 1 [1 to 5], p = 0.004), tip (median [IQR] 0.33 [0 to 0.75] vs 1 [0.58 to 1.5], p = 0.006), and 3-jaw (median [IQR] 0.5 [0 to 0.92] vs 1.08 [0.41 to 2], p = 0.043) pinch strength. In evaluating the satisfaction of participants in both groups, higher mean scores were observed in the control group. No statistically significant difference in most of the questions in the satisfaction survey in both groups. All participants in both groups displayed 100% compliance in attending onsite treatments. Despite not showing statistically significant difference between groups (p = 0.721), an 11.8% tendency for better compliance is found in the intervention group. Conclusion. The specific guitar lesson created and performed in this study as used by 17 participants of the intervention group have brought about improvement in hand function that is comparable with those who underwent traditional occupational therapy. This may be most helpful in areas with limited access to rehabilitation facilities and occupational therapy services. This may also be used as a continuing activity of chronic stroke patients at home to help improve hand function.

Sensor-Derived Measures of Motor and Cognitive Functions in People With Multiple Sclerosis Using Unsupervised Smartphone-Based Assessments: Proof-of-Concept Study.

Smartphones and wearables are revolutionizing the assessment of cognitive and motor function in neurological disorders, allowing for objective, frequent, and remote data collection. However, these assessments typically provide a plethora of sensor-derived measures (SDMs), and selecting the most suitable measure for a given context of use is a challenging, often overlooked problem. This analysis aims to develop and apply an SDM selection framework, including automated data quality checks and the evaluation of statistical properties, to identify robust SDMs that describe the cognitive and motor function of people with multiple sclerosis (MS). The proposed framework was applied to data from a cross-sectional study involving 85 people with MS and 68 healthy participants who underwent in-clinic supervised and remote unsupervised smartphone-based assessments. The assessment provided high-quality recordings from cognitive, manual dexterity, and mobility tests, from which 47 SDMs, based on established literature, were extracted using previously developed and publicly available algorithms. These SDMs were first separately and then jointly screened for bias and normality by 2 expert assessors. Selected SDMs were then analyzed to establish their reliability, using an intraclass correlation coefficient and minimal detectable change at 95% CI. The convergence of selected SDMs with in-clinic MS functional measures and patient-reported outcomes was also evaluated. A total of 16 (34%) of the 47 SDMs passed the selection framework. All selected SDMs demonstrated moderate-to-good reliability in remote settings (intraclass correlation coefficient 0.5-0.85; minimal detectable change at 95% CI 19%-35%). Selected SDMs extracted from the smartphone-based cognitive test demonstrated good-to-excellent correlation (Spearman correlation coefficient, |ρ|>0.75) with the in-clinic Symbol Digit Modalities Test and fair correlation with Expanded Disability Status Scale (EDSS) scores (0.25≤|ρ|<0.5). SDMs extracted from the manual dexterity tests showed either fair correlation (0.25≤|ρ|<0.5) or were not correlated (|ρ|<0.25) with the in-clinic 9-hole peg test and EDSS scores. Most selected SDMs from mobility tests showed fair correlation with the in-clinic timed 25-foot walk test and fair to moderate-to-good correlation (0.5<|ρ|≤0.75) with EDSS scores. SDM correlations with relevant patient-reported outcomes varied by functional domain, ranging from not correlated (cognitive test SDMs) to good-to-excellent correlation (|ρ|>0.75) for mobility test SDMs. Overall, correlations were similar when smartphone-based tests were performed in a clinic or remotely. Reported results highlight that smartphone-based assessments are suitable tools to remotely obtain high-quality SDMs of cognitive and motor function in people with MS. The presented SDM selection framework promises to increase the interpretability and standardization of smartphone-based SDMs in people with MS, paving the way for their future use in interventional trials.

Smartphone-Based Assessment of Mobility and Manual Dexterity in Adult People with Spinal Muscular Atrophy.

More responsive, reliable, and clinically valid endpoints of disability are essential to reduce size, duration, and burden of clinical trials in adult persons with spinal muscular atrophy (aPwSMA). The aim is to investigate the feasibility of smartphone-based assessments in aPwSMA and provide evidence on the reliability and construct validity of sensor-derived measures (SDMs) of mobility and manual dexterity collected remotely in aPwSMA. Data were collected from 59 aPwSMA (23 walkers, 20 sitters and 16 non-sitters) and 30 age-matched healthy controls (HC). SDMs were extracted from five smartphone-based tests capturing mobility and manual dexterity, which were administered in-clinic and remotely in daily life for four weeks. Reliability (Intraclass Correlation Coefficients, ICC) and construct validity (ability to discriminate between HC and aPwSMA and correlations with Revised Upper Limb Module, RULM and Hammersmith Functional Scale - Expanded HFMSE) were quantified for all SDMs. The smartphone-based assessments proved feasible, with 92.1% average adherence in aPwSMA. The SDMs allowed to reliably assess both mobility and dexterity (ICC > 0.75 for 14/22 SDMs). Twenty-one out of 22 SDMs significantly discriminated between HC and aPwSMA. The highest correlations with the RULM were observed for SDMs from the manual dexterity tests in both non-sitters (Typing, ρ= 0.78) and sitters (Pinching, ρ= 0.75). In walkers, the highest correlation was between mobility tests and HFMSE (5 U-Turns, ρ= 0.79). This exploratory study provides preliminary evidence for the usability of smartphone-based assessments of mobility and manual dexterity in aPwSMA when deployed remotely in participants' daily life. Reliability and construct validity of SDMs remotely collected in real-life was demonstrated, which is a pre-requisite for their use in longitudinal trials. Additionally, three novel smartphone-based performance outcome assessments were successfully established for aPwSMA. Upon further validation of responsiveness to interventions, this technology holds potential to increase the efficiency of clinical trials in aPwSMA.

Impact of manual dexterity on toothbrushing efficacy in typically developing children: A cross-sectional study.

Manual dexterity includes gross motor skills (GMS) and fine motor skills (FMS). Literature reports manual dexterity as a contributing factor for improved oral hygiene and that the required dexterity for toothbrushing develops above 8 years of age. Research suggests grip force, movement speed, and motor coordination should be assessed to improve knowledge on kinetics of brushing teeth. To assess the impact of manual dexterity on toothbrushing efficacy in 7 to 12 year old children. The cross-sectional study included 150 typically developing 7-12 year old children. Oral health status was recorded using the Decayed, Missing, and Filled Teeth index. GMS and FMS were evaluated using the MInnesota Manual Dexterity Test (MMDT) and Archimedes spiral test (AST), respectively. Toothbrushing efficacy was determined by Turesky modification of Quigley-Hein Plaque Index- difference in mean scores from before and after toothbrushing. Assessment of GMS, FMS, and toothbrushing efficacy using ANOVA showed a significant increase with age (p value: 0.000); unpaired t-test showed an association of toothbrushing efficacy with GMS and FMS irrespective of age (p value: 0.000). Manual dexterity was significantly associated with toothbrushing efficacy in typically developing children. AST, a simple test to determine FMS, may help paediatric dentists to guide parents on the supervision of toothbrushing for their child.

Contribution of a Tablet-Based Tests to the Diagnosis of Neurocognitive Disorders in Older Adults: A Feasibility Study.

Neurocognitive diseases are diagnosed in specialized centers such as memory clinics, where the waiting time can be long. The reference assessment involves a battery of tests carried out by a specialized team. Facilitating screening in primary care using new technologies could make it possible to appropriately direct care pathways towards specialist care. This work aimed to set up a battery of questionnaires, cognitive and manual dexterity tests on a digital tablet to screen people with cognitive impairment. Three groups of people are recruited from a memory consultation: people with major neurocognitive disorders, people with mild neurocognitive disorders and people with no cognitive impairment. Initial results in geriatric settings show that the digital tablet assessment test is feasible and well accepted, but that manual dexterity assessment needs to be adapted to the bodily particularities of the very old.

Portable Touchscreen Assessment of Motor Skill: A Registered Report of the Reliability and Validity of EDNA MoTap.

Portable and flexible administration of manual dexterity assessments is necessary to monitor recovery from brain injury and the effects of interventions across clinic and home settings, especially when in-person testing is not possible or convenient. This paper aims to assess the concurrent validity and test-retest reliability of a new suite of touchscreen-based manual dexterity tests (called EDNA™MoTap) that are designed for portable and efficient administration. A minimum sample of 49 healthy young adults will be conveniently recruited. The EDNA™MoTap tasks will be assessed for concurrent validity against standardized tools (the Box and Block Test [BBT] and the Purdue Pegboard Test) and for test-retest reliability over a 1- to 2-week interval. Correlation coefficients of r > .6 will indicate acceptable validity, and intraclass correlation coefficient (ICC) values > .75 will indicate acceptable reliability for healthy adults. The sample were primarily right-handed (91%) adults aged 19 and 34 years (M = 24.93, SD = 4.21, 50% female). The MoTap tasks did not demonstrate acceptable validity, with tasks showing weak-to-moderate associations with the criterion assessments. Some outcomes demonstrated acceptable test-retest reliability; however, this was not consistent. Touchscreen-based assessments of dexterity remain relevant; however, there is a need for further development of the EDNA™MoTap task administration.

Cold Habituation Does Not Alter Thermal Responses or Manual Dexterity During Prolonged Cold Air Exposure

Background: Habituation is a pattern of cold acclimatization characterized by attenuated cold defense responses, including a reduction in peripheral vasoconstriction and subsequent increase in skin temperature (TSk) as well as a decrease in shivering thermogenesis. Habituation is achieved through repeated reductions in TSk, rather than deep body core temperature (TC), via exposure to prolonged cold air or brief cold-water immersion. Due to improvements in TSk, enhanced manual dexterity and peripheral cold injury risk reduction are purported benefits of cold habituation. Warfighters frequently operate in cold climates and experience decrements in manual dexterity and strength. These functional losses can negatively impact mission critical tasks and training exercises; however, the effectiveness of cold habituation as a potential countermeasure to alleviate the deleterious effects of prolonged cold exposure on peripheral temperatures, thermal comfort, and hand function is unclear. Purpose: To evaluate the influence of eight consecutive cold air exposures on the thermal (TC and TSk), perceptual (thermal comfort and sensation), and functional (manual dexterity and strength) responses to cold air. We hypothesized that TSk would be higher and perceptual responses and manual dexterity improved, following repeated cold exposure. Methods: Eight young adults (6 M/1 F/1 FTM; 21 ± 2 years; %BF 24.5 ± 7.0) underwent a 2-h cold air exposure (8 °C, ~50% RH) on 8 consecutive days wearing minimal clothing. On Day 0 (baseline exposure ~1 week prior) and Days 1 and 8 of repeated exposure, TC was recorded continuously via a telemetry pill used as a rectal suppository. Extremity (Thand and Tfinger) and mean weighted TSk (MWTSk) from 8 skin sites were recorded continuously. Thermal comfort (TC) and thermal sensation (TS) were recorded at 20 min intervals. Expired gases were collected at 20 min intervals and used to calculate metabolic heat production (MHP). Manual dexterity was assessed using the Purdue Pegboard and Minnesota Manual Dexterity Test (MMDT), and hand strength were measured before and at the end of cold exposure. Results: TC changed across time ( p &lt; 0.05) but did not differ between days ( p &gt; 0.05). MWTSk, Thand, and Tfinger decreased across time ( p &lt; 0.05) but also did not differ between days ( p &gt; 0.05). Mean and minimum whole-body TS and TC were not different between days ( p &gt; 0.05). MHP increased across time ( p &lt; 0.05) but did not differ between days ( p &gt; 0.05). Purdue Pegboard, MMDT task performance, and hand strength did not differ between days ( p &gt; 0.05). Conclusion: Eight consecutive days of cold air exposure does not augment extremity skin temperature, thermal comfort, or manual performance during prolonged cold conditions. Supported by U.S. Army Medical Research and Development Command, Military Operational Medicine Research Program; author views not offcial US Army or DoD policy. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Encoding Manual Dexterity through Modulation of Intrinsic α Band Connectivity.

The human hand possesses both consolidated motor skills and remarkable flexibility in adapting to ongoing task demands. However, the underlying mechanisms by which the brain balances stability and flexibility remain unknown. In the absence of external input or behavior, spontaneous (intrinsic) brain connectivity is thought to represent a prior of stored memories. In this study, we investigated how manual dexterity modulates spontaneous functional connectivity in the motor cortex during hand movement. Using magnetoencephalography, in 47 human participants (both sexes), we examined connectivity modulations in the α and β frequency bands at rest and during two motor tasks (i.e., finger tapping or toe squeezing). The flexibility and stability of such modulations allowed us to identify two groups of participants with different levels of performance (high and low performers) on the nine-hole peg test, a test of manual dexterity. In the α band, participants with higher manual dexterity showed distributed decreases of connectivity, specifically in the motor cortex, increased segregation, and reduced nodal centrality. Participants with lower manual dexterity showed an opposite pattern. Notably, these patterns from the brain to behavior are mirrored by results from behavior to the brain. Indeed, when participants were divided using the median split of the dexterity score, we found the same connectivity patterns. In summary, this experiment shows that a long-term motor skill-manual dexterity-influences the way the motor systems respond during movements.

Extended reality to assess post-stroke manual dexterity: contrasts between the classic box and block test, immersive virtual reality with controllers, with hand-tracking, and mixed-reality tests

BackgroundRecent technological advancements present promising opportunities to enhance the frequency and objectivity of functional assessments, aligning with recent stroke rehabilitation guidelines. Within this framework, we designed and adapted different manual dexterity tests in extended reality (XR), using immersive virtual reality (VR) with controllers (BBT-VR-C), immersive VR with hand-tracking (BBT-VR-HT), and mixed-reality (MD-MR).ObjectiveThis study primarily aimed to assess and compare the validity of the BBT-VR-C, BBT-VR-HT and MD-MR to assess post-stroke manual dexterity. Secondary objectives were to evaluate reliability, usability and to define arm kinematics measures.MethodsA sample of 21 healthy control participants (HCP) and 21 stroke individuals with hemiparesis (IHP) completed three trials of the traditional BBT, the BBT-VR-C, BBT-VR-HT and MD-MR. Content validity of the different tests were evaluated by asking five healthcare professionals to rate the difficulty of performing each test in comparison to the traditional BBT. Convergent validity was evaluated through correlations between the scores of the traditional BBT and the XR tests. Test-retest reliability was assessed through correlations between the second and third trial and usability was assessed using the System Usability Scale (SUS). Lastly, upper limb movement smoothness (SPARC) was compared between IHP and HCP for both BBT-VR test versions.ResultsFor content validity, healthcare professionals rated the BBT-VR-HT (0[0–1]) and BBT-MR (0[0–1]) as equally difficult to the traditional BBT, whereas they rated BBT-VR-C as more difficult than the traditional BBT (1[0–2]). For IHP convergent validity, the Pearson tests demonstrated larger correlations between the scores of BBT and BBT-VR-HT (r = 0.94;p < 0.001), and BBT and MD-MR (r = 0.95;p < 0.001) than BBT and BBT-VR-C (r = 0.65;p = 0.001). BBT-VR-HT and MD-MR usability were both rated as excellent, with median SUS scores of 83[57.5–91.3] and 83[53.8–92.5] respectively. Excellent reliability was found for the BBT-VR-C (ICC = 0.96;p < 0.001), BBT-VR-HT (ICC = 0.96;p < 0.001) and BBT-MR (ICC = 0.99;p < 0.001). The usability of the BBT-VR-C was rated as good with a median SUS of 70[43.8–83.8]. Upper limb movements of HCP were significantly smoother than for IHP when completing either the BBT-VR-C (t = 2.05;p = 0.043) and the BBT-VR-HT (t = 5.21;p < 0.001).ConclusionThe different XR manual tests are valid, short-term reliable and usable tools to assess post-stroke manual dexterity.Trial registrationhttps://clinicaltrials.gov/ct2/show/NCT04694833; Unique identifier: NCT04694833, Date of registration: 11/24/2020.

Disparities in DMT treatment: Demographic and neurocognitive differences between MS patients currently treated versus not treated with disease-modifying therapies

BackgroundCurrent treatment guidelines recommend consideration of disease-modifying therapy (DMT) for all multiple sclerosis (MS) patients, but barriers to access have begun to be identified. In particular, prior studies have found that people with higher education have better access to DMTs, perhaps explained by the association of higher education with higher income. And while the majority of people with MS are women, being male is also associated with higher income. These factors argue for the need to better understand whether there are differences in DMT uptake based on sex and education. Finally, in addition to well-documented benefits of DMTs for slowing disease progression, there is growing evidence to suggest benefits of DMTs for cognitive functioning. ObjectiveDetermine whether rates of DMT treatment differ based on education and sex. Secondarily, we investigate whether neurocognitive test performance differs in treated versus not treated groups. MethodsIn cross-sectional data, mixed effects linear regression evaluated differences in education and sex of those treated versus not treated with DMTs. Models included the following predictors: age, disease duration, MS subtype, sex/education, disability, atrophy, and T2 lesion volume. Propensity score weights were extracted to obtain unbiased estimates of the relationship between DMT status and each outcome of interest. The same models evaluated performance differences between groups on an iPad-based processing speed test (PST) and manual dexterity test (MDT). ResultsControlling for covariates, individuals with less education (OR=1.09, 95 % CI=[1.03, 1.14], p = 0.003) and women (OR=0.80, 95 % CI=[0.72, 0.90], p < 0.001) were less likely to be currently treated with DMTs. Small effect size association was shown for DMT treatment with better performance on PST (beta=0.09, CI=[0.06, 0.13], p < 0.001) and MDT (beta=0.05, CI=[0.01,0.08], p = 0.011). ConclusionsWomen and people with lower education had a lower likelihood of being currently treated with DMTs. After controlling for all relevant variables, an independent (small) association of DMT treatment to better performance on tests of processing speed and fine motor dexterity was found. Reasons for disparities remain to be investigated in future work, and may include employment status, health insurance coverage, or sex differences in risk tolerance.

Motor difficulties from childhood to midlife: A 40-year cohort study

BackgroundThere are few studies of the persistence of childhood motor difficulties (MD) into adulthood. AimsTo investigate the association of childhood MD with motor skills and body mass index (BMI) in midlife. Methods and proceduresWe studied 324 adults aged 40 from a cohort born in 1971–1974. At age 9, they had undergone the Test of Motor Impairment, used to classify them into groups: childhood MD (cMD), borderline cMD (bcMD), or no cMD. At age 40, participants comprised 23 with cMD, 47 with bcMD, and 254 with no cMD. Participants completed motor tests of balance, manual dexterity, and visuomotor speed, followed by recording of their BMI. Outcomes and resultsAt age 40, the cMD group performed worse than the no-cMD group on all motor tests (p < .001–.008). The bcMD group had slower visuomotor speed than the no-cMD group (p = .025). The groups differed in BMI (p = .002). Having cMD was associated with obesity in midlife (p < .001). After adjusting for sex, childhood socioeconomic status, and BMI at age 9, both cMD and bcMD were associated with obesity in midlife (p = .015). Conclusions and implicationsChildhood MD are associated with poor motor skills, overweight, and obesity in midlife. This emphasises the importance of early intervention and follow-up when a child exhibits MD. What this paper addsThis prospective longitudinal study presents novel evidence that individuals with a history of comprehensively and objectively assessed childhood motor difficulties (MD) have worse motor skills and a higher risk of obesity in midlife than do those with no childhood MD. There is a growing literature on adults with developmental coordination disorder or a history of MD. There is, however, a scarcity of longitudinal studies of childhood MD that continue beyond early adulthood, into midlife. In a systematic search, we could identify only one longitudinal study of objectively measured childhood MD with a reassessment of motor skills in those same participants in adulthood, and no study with a reassessment after age 20. Furthermore, longitudinal studies of the association of comprehensively and objectively assessed childhood MD with BMI in midlife have been lacking.

The effects of exergames on upper extremity performance, trunk mobility, gait, balance, and cognition in Parkinson's disease: a randomized controlled study.

In recent years, game-based exercises have been included more in the rehabilitation programs of Parkinson's disease (PD) patients and positive effects have been observed. This study aims to investigate the effects of innovative games particularly designed for neurological patients on upper extremity performance, trunk mobility and cognition in patients with PD. Twenty-three patients were enrolled in this randomized controlled study and randomly allocated into two groups: Exergames Program (EP) and Conventional Exercise Program (CP). Both groups received supervised physiotherapy sessions for 3days a week and 8weeks in total (24 sessions). Each session lasted 1h. Evaluations were applied before and after the treatment: 9-Hole Peg Test (9-HPT), Minnesota Manual Dexterity Test (MMDT), Trunk Impairment Scale (TIS), Montreal Cognitive Assessment (MoCA), Unified Parkinson's Disease Rating Scale (MDS-UPDRS), Timed Up and Go (TUG), Functional Reach Test (FRT), and Parkinson Disease Questionnaire (PDQ-39). Twenty patients were included in the analysis because of the dropouts. Our findings showed that both groups improved significantly in 9-HPT dominant side, MMDT, TIS, MDS-UPDRS, TUG, FRT, and PDQ-39 (p < 0.05). MoCA scores of EP group improved significantly (p < 0.05) while CP group's did not (p > 0.05). It was found that EP group had better improvements in 9-HPT dominant side, MMDT turning test, and MoCA than CP group when the differences in the changes within the groups were compared (p < 0.05). Game-based training can be a useful rehabilitation tool to improve upper extremities performance, trunk mobility, cognition, functional mobility, balance, and quality of life and may have superiority over conventional exercises in improving cognition and upper extremity functions. NCT05235880. Release Date: April 1, 2022.

The Canadian Prospective Cohort Study to understand progression in multiple sclerosis: baseline characteristics.

Disease progression is observed across the spectrum of people with multiple sclerosis (MS) and identification of effective treatment strategies to halt progression remains one of the greatest unmet clinical needs. The Canadian Prospective Cohort Study to Understand Progression in MS (CanProCo) was designed to evaluate a wide range of factors associated with the onset and rate of clinical disease progression in MS and to describe the interplay between these factors. A prospective cohort study. CanProCo is a national, prospective, observational cohort study that has recruited 944 individuals from 5 large academic MS centers in Canada. Participants include people with radiologically isolated syndrome (RIS), early relapsing-remitting and primary progressive MS (RRMS, PPMS), and healthy controls (HCs). Annually, participants complete self-reported questionnaires, undergo clinical evaluation and, if clinically indicated, magnetic resonance images (MRIs) of the brain and cervical spinal cord; in a subset of participants (n = 399), blood, and research MRIs of the brain and cervical spinal cord are collected. Linkages to health administrative databases are available at three sites. Overall, 944 participants were recruited (53 HCs, 63 RIS, 751 RRMS, 77 PPMS). RIS and MS participants had a mean age of 39.0 years and 70.5% female. The mean time since diagnosis was 2.7 years. There were differences observed in the Expanded Disability Status Scale score and components of the MS performance test (walking speed test, manual dexterity test, processing speed test, and low-contrast visual acuity) between RIS and MS subtypes. Questionnaires revealed more symptoms of depression and anxiety and impaired physical and mental quality of life in people with RIS/MS versus HCs and differences across RIS/MS subtypes. Physical and mental neurological disability is prevalent even in the earliest stages of MS. Transdisciplinary approaches such as those used in CanProCo are needed to better characterize clinical progression in MS. Additional CanProCo results, including MRI, biological, and pharmaco-economic data will be forthcoming. Going forward, CanProCo's data sharing and collaborative vision will facilitate numerous global collaborations, which will inform the development and implementation of effective interventions for people with MS around the world.

Postshift Hand Fatigue in Emergency Service Nurses

Objective: Hand functionality, defined as the ability to perform tasks requiring fine motor skills, is crucial for emergency service nurses as it directly affects their ability to perform tasks requiring fine motor skills, such as administering medication, operating equipment, and providing patient care. This study, therefore, aimed to investigate the effects of an 8‐h work shift on hand functionality and perceived exertion among emergency service nurses.Method: Employing a cross‐sectional design, the study measured manual dexterity, handgrip, and pinch strength, and perceived exertion using the Minnesota Manual Dexterity Test (MMDT), Nine‐Hole Peg Test (9‐HPT), Handgrip Strength Test, Pinch Strength Test, and the Borg Rating of Perceived Exertion (RPE) Scale. Data were collected from 34 emergency service nurses both before and after their shifts.Results: The present findings indicated significant postshift declines in manual dexterity as evidenced by the MMDT and 9‐HPT, with the former demonstrating a large effect size and the latter a small effect size. No significant changes were observed in handgrip and pinch strength. Notably, Borg RPE scores increased significantly postshift, indicating substantial perceived fatigue with a nearly perfect effect size. Correlation analyses revealed significant relationships between increased physical exertion and changes in hand dexterity and strength, underscoring the physical demands placed on nurses during typical work shifts.Conclusions: These findings highlight the need for healthcare institutions to reassess work schedules and ergonomic practices to mitigate fatigue and preserve nurses’ hand functionality, thereby enhancing patient care and nurse well‐being. The study calls for further research to explore more comprehensive strategies aimed at reducing the occupational strain on emergency service nurses.

QOL-04. CHANGES IN FUNCTIONAL CONNECTIVITY AFTER SURGERY ARE ASSOCIATED WITH DECLINE IN FUNCTIONAL INDEPENDENCE IN PATIENTS WITH ELOQUENT GLIOMA

Abstract It is unknown whether patient independence following resection of eloquent glioma is associated with postoperative functional connectomic changes. Fifteen patients with left perisylvian glioma underwent resting-state fMRI and neuropsychological evaluation before and about 1 month after resection. Functional independence was measured with the Physical Self-Maintenance Scale (PSMS) and the Instrumental Activities of Daily Living scale (IADL). Manual dexterity testing (Grooved Pegboard; N = 13), neurologic motor exam (N = 12), and performance status (KPS; N = 14) were also obtained. Graph theoretical analysis was used to calculate functional brain network properties. Postoperative need for assistance in at least 1 activity on the IADL increased from baseline in 80% of patients, most commonly in Transportation (67%), followed by Shopping (60%), Financial Management (47%), Cooking (47%), Medication Management (33%), and Phone Use (33%). Overall need for assistance (Total IADL score) significantly increased postoperatively (Mdn change = 4, p = .006). Need for assistance on the PSMS only increased in 27% of patients, with rates less than 15% across all functions. Total PSMS scores did not differ pre- and postoperatively (Mdn change = 0). KPS scores worsened in 40% of patients. None had gross motor worsening, though fine manual dexterity declined in 7% for the left and 23% for the right hand. Increased connectomic properties were significantly associated (Spearman ρ) with greater need for assistance on the IADL [Local Efficiency: Total (.72), Shopping (.71), Cooking (.64), Financial Management (.64); Clustering Coefficient: Phone Use (.63); Betweenness Centrality: Phone Use (.63); all p &amp;lt; .01]. PSMS and IADL ratings were not associated with KPS, manual dexterity, pre/postoperative FLAIR volume, or extent of resection. This study demonstrated that increases in certain functional connectomic properties after surgery are associated with greater need for assistance in instrumental activities in the postoperative period. Connectivity increases have also been associated with poorer cognitive outcome in this population, though specific properties involved may differ.

Investigation Of Factors Affecting Motor Competence In Early Adolescents

Aim: This study aims to retrospectively evaluate the fundamental motor competence of early adolescents and to examine the affecting factors. Methods: 89 children aged 11.33±0.95 were included in the study. Minnesota Manual Dexterity Test (MMDT) for manual dexterity, 9-Hole Peg Test (9-HPT) for finger dexterity, Korebalance™ Premiere for balance, manual muscle strength measurement device for quadriceps muscle strength, hand dynamometer for hand grip strength, EMG Biofeedback for muscle activation was used. Results: Compared by gender, there was a statistically significant difference in the right and left-hand placing of MMDT and 9-HPT (p=0.004, p=0.041, p=0.004, respectively). Comparison’s of age groups, there was a statistically significant difference in the left-hand placing and turning subtests of MMDT and left grip strength (p=0.010, p=0.048, p=0.025, respectively). In a correlation analyses, age had a correlation with the left-hand placing of MMDT (r=-0.336,p=0.001); and left grip strength (r=0.219,p=0.039). Height and weight had a correlation with dynamic balance (r=-0.242,p=0.022; r=-0.244,p=0.021). Weight and BMI had a correlation with static balance (r=0.342,p=0.001; r=0.305,p=0.004) and EMG Biofeedback score (r=0.237,p=0.025; r=0.212,p=0.046). Conclusion: Manual dexterity and hand grip strength develop with age in children, and girls' manual and finger dexterities are better than boys. While the increase in BMI and weight affect static balance negatively, the increase in height and weight affect dynamic balance positively. It is thought that investigating the factors affecting motor competence will be important in evaluating the development of children and directing them to appropriate sports.&#x0D; Keywords: Balance, Manual dexterity, Finger dexterity, Muscle activation

Evaluation of manual dexterity when using a mirror of dental students and academicians with increasing professional experience.

To evaluate the manual dexterity of dentistry students and academicians when using a mirror according to increasing professional experience. The study included 72 subjects, grouped according to professional experience 5th year dentistry students (DS) accepted as no experience-academicians with 1-4 years experience (A5L)-academicians with ≥5 years experience (A5M). Direct and indirect visualisation using the mirror was evaluated with the completion times of the O'Connor Finger Dexterity Test. The hand grip strength values of both left and right hand were found to be statistically significantly higher in all the males than in the females (p < .05). The indirect test times (ITT) using the mirror were significantly longer for males than for females (p = .001), and no significant difference was determined between the genders in the direct test times (DTT) (p > .05). For all the study participants, DTT shortened as professional experience increased (p < .05). In addition, the mean values of both DTT (p = .031) and ITT (p = .028) in the DS group were statistically significantly longer than the A5M group. With increasing professional experience, manual dexterity was determined to increase, and females were found to be more successful in the direct manual dexterity tests independently of the groups. The statistical significance between the DS and A5M groups, especially in the hand dexterity test with a mirror, shows the importance of experience. The study results demonstrated that professional manual dexterity in dentistry can be developed with increasing practical application.

Assessment of sensorimotor and strength related function of breast cancer patients during systemic drug therapy: a prospective observational study

BackgroundChemotherapy is a well-known risk factor for sensorial and motor disturbances. Chemotherapy induced peripheral neuropathy (CIPN) which predominantly affects sensory nerves might cause a diminished fine motor function. This prospective observational study aimed to assess the sensorimotor functions of breast cancer patients before, during, and after chemotherapy.MethodsA total of 56 breast cancer patients were evaluated at three different times as follows: T1 (before chemotherapy), T2 (middle chemotherapy), and T3 (completion of chemotherapy). Motor function was assessed with handgrip strength (HGS), peripheral muscle strength (PMS), and the Minnesota Manual Dexterity Test (MMDT). Semmes Weinstein Monofilament Test (SWMT) was performed to assess the sensory function. Fatigue was evaluated with the European Organization for Research and Treatment of Cancer Quality of Life Module Cancer Related Fatigue (EORTC-QLQ-FA12), respectively.ResultsHGS and MMDT were found significant (χ2: 11.279, p = 0.004 and χ2: 9.893, p = 0.007, respectively) whereas PMS was not found significant (F (2,110) = 1.914, p = 0.152). Pairwise comparisons with Bonferroni adjustments revealed that HGS was found significant between T1 and T3, while significant results were obtained between T1 and T2 as well as T2 and T3 in MMDT (p = 0.01 and p = 0.042). There were significant results in some reference points of SWMT, though they were not found after pairwise comparisons with Bonferroni adjustment (p > 0.05). Fatigue was found significantly increased from T1 through T3 (Median: 19.44 vs 27.77, z: -2.347, p = 0.019, Wilcoxon test).ConclusionOur study showed that decreased handgrip strength and fine motor function, as well as increased fatigue, are evident during the chemotherapy. SWMT can be an optional assessment in the context of tracking changes in cutaneous sensation during chemotherapy due to its non-invasive, cheap, and easily repeatable features among cancer patients. To preserve functional capacity as well as independence in daily living, precautions and follow up assessments during the systemic therapy process should be integrated as early as possible to prevent future deteriorations in daily life for patients who undergo chemotherapy.Trial registrationNCT04799080.

Sağlık Hizmetleri Meslek Yüksekokulu öğrencilerinde el morfometrik ölçümlerinin el becerisine etkisi

Purpose: This paper aimed to evaluate the manual dexterity tests and hand morphometry, and to research whether the dexterity tests and hand lengths were affected by gender and body mass index (BMI) or not. &#x0D; Materials and Methods: This study was carried out on 114 adult subjects aged between 18 and 25 years (37 males and 77 females). Demographic characteristics including gender, age, dominant hand, height, weight, and body mass index (BMI) of all subjects were recorded. Additionally, hand morphometric measurements and manual dexterity tests called as O’Connor Finger Dexterity Test and Purdue Pegboard Test were applied.&#x0D; Results: Some values such as the hand length (right and left), palmar length (right and left), dominant and non-dominant hand finger, and O’Connor Finger Dexterity Test-Left side showed significant differences between genders. Additionally, O’Connor Finger Dexterity Test scores for both sides were lower in males than in females. Purdue Pegboard-Right, and Purdue Pegboard-Left, Purdue Pegboard-Both Hands, Purdue Pegboard total were higher in males, whereas Purdue Pegboard (Assembly) was higher in females than in males. However, Purdue Pegboard measurement scores did not show a significant difference between genders.&#x0D; Conclusion: Hand morphometric measurements and manual dexterity tests showed some changes in terms of gender and BMI. Additionally, the data obtained can provide crucial information for therapists and clinicians about hand rehabilitation.