Upper Limb Dexterity in Multiple Sclerosis Patients: An Important and Underrated Morbidity
Abstract Background: Scales to assess disability in multiple sclerosis (MS) rarely provides reliable data on the actual global impairment. Upper limbs (UL) dysfunction is usually overlooked, which has a negative impact on the patient's well-being. Objectives: 1) to analyze the association between UL dexterity, lower limbs (LL) speed and the EDSS score. 2) To analyze the difference in UL dexterity between patients with EDSS <5 and ≥5. 3) To study the association that UL dexterity, LL speed and the EDSS score have with both health-related quality of life measurements and depression. Methods: Our sample included 140 adults with MS. They were evaluated using the Nine-Hole Peg Test, the Timed 25-Foot Walk test, the EDSS, the Multiple Sclerosis International Quality of Life questionnaire (MusiQol), and the Beck Depression Inventory. We conducted a thorough descriptive-analytical research using Spearman's correlation, multiple linear regression and structural equation modeling. Results: UL dexterity was more closely related to the EDSS than LL speed (r: 0.43 vs. 0.29, R2: 0.38). UL dexterity was greatest in patients with EDSS <5 (P < .001). Moreover, UL dexterity was negatively associated with EDSS and the MusiQol (rS: between −0.557 and −0.358, P < .05). The correlation that depression has with loss of dexterity in UL was higher than the one it has with LL speed (0.098 vs 0.066, t > 1.96). Conclusions: UL dexterity is associated and global disability, depression, and health-related quality of life. We advocate for the assessment of UL dexterity during MS patients' consultations to adopt a better approach to their functional impairment.