The relationship between walking, manual dexterity, cognition and activity/participation in persons with multiple sclerosis

Abstract

The proposed cut-off values in the 2 × 5 m walk test and the Nine-hole Peg Test may be used as indicators of functioning and to identify persons risking activity limitations and participation restrictions. However, further studies are needed to confirm the usefulness in clinical practice.

Physical activity and exercise training in multiple sclerosis: a review and content analysis of qualitative research identifying perceived determinants and consequences

“…Indeed, increased social participation was perceived by a widevariety of persons with MS, and identified in high-quality studies. Social participation is negatively correlated with a range of clinical MS outcomes [74,75] in persons with MS, leading to decreased health and economic burdens [75]. Therefore, it is important that the most common perceived social outcome was increased social participation and this finding should fuel further study into the participatory benefits of physical activity and exercise.…”

Assessing walking disability in multiple sclerosis

“…1 Versus activity/participation measures ( Table 3). The 10MTW walking speed was moderately to strongly correlated with measures of independence in ADL and participation in social and lifestyle activities, 37 and the 6mWT distance was strongly correlated with the Barthel index score, a measure of functional independence in ADL. 22 Slower walking time on the 10MTW and shorter distances walked on the 6mWT were among the most significant predictors of perceived difficulties in performing ADL in MS patients.…”

“…39,50 Another study found a 1 m/sec change in the 10MTW had good sensitivity and specificity for predicting limitations in activities and participation in ADLs. 37 The smallest reliable change in the 30MTW at forced walking speed was an increase of 40% or a decrease of 29% in time based on day-to-day variability. 13 Walking distance assessments.…”

“…46 The 10MTW was deemed to have adequate responsiveness based on receiver operator curve (ROC) analysis in both mildly disabled patients with MS 39 and in patients with EDSS 0-6.5; 13 however, there was little consensus among studies on what constitutes an MICD for the 10MTW. 37,39,49,50 Reliable changes on the 10MTW have been defined as an improvement of 23% or a worsening of 30% in time, 13 an increase of 0.17 m/sec or decrease of 0.12 m/sec in speed, 20 a change of 0.26 m/sec in speed 49 and a change of 28% in time. 35 Although one study found a MICD for deterioration (MICD det ) of -0.08 and -0.14 m/sec at normal speed and -0.19 and -0.11 m/sec at fastest speed on the 10MTW based on clinician and patient perception of change, respectively, 49 other studies were unable to define a reliable MICD det for this measure.…”

Assessment of Upper Extremity Function in Multiple Sclerosis: Review and Opinion

“…In particular, studies in older adults and in people with disease states such as stroke have shown that grip strength is predictive of poorer health status, worse outcomes including loss of independence, and increased morbidity and mortality. [9][10][11] In people with MS, manual dexterity, assessed using the 9-Hole Peg Test, was shown to be a useful indicator of risk for activity limitations and participation restrictions such as ability to perform activities of daily living (ADLs), 12 Additionally, the magnitude of UE impairment was shown to affect the level of independence and to negatively impact quality of life. 13 Subtle UE dysfunction may be present even in early MS, affecting performance of manipulation tasks and having a functional impact by producing disability and reducing the ability to perform ADLs.…”