Conf Proc IEEE Eng Med Biol Soc. 2015 Aug;2015:6967-6970.
The goal of this study was to investigate the movement and muscle activity of the upper limb during common activities of daily life in people withMultiple Sclerosis (PwMS) with low and mild-moderate level of upper limb impairments. We found significant changes in muscles activity in PwMS compared to healthy subjects when holding and lifting objects used in everyday life. These differences were particularly remarkable in subjects with moderate level of impairment, in which the disease affected also movement smoothness. Remarkably, the smoothness of the movement during the interaction with common objects of daily activities highly correlated with the subjects’ ability measured with the Abilhand scale.
For too long outcomes have focussed on the EDSS as the major outcome for disability. This essentially a mobility scale heavily focussed on walking and lower limb function. The regulators seem to welded to the hip on this one, but it has significant problems and it takes a while to assess it properly and it is subject to wiggle and can change depending on various factors such as how many canes you use from day to day. Likewise it may not capture problems that are relevant to people with MS. It is also a stepwise scale and is not truely quantitative and insensitive to change.
The sanitized EDSS.
Why are the regulators being dinosaurs?
However if you are immobile do you just get lumped into an EDSS 7-9 and if you are EDSS 7 this excludes you from many, many trials.
Why can’t we think outside the box and get upper body function as a main outcome. We have alot more nerves controlling our hands than our feet and our hands have alot more fine control than our feet.
This study looks a hand movements and can find influences in people with MS, some of these correlate with the Abihand scale (click here to find out more about the Abihand scale). The Nine hole peg test are other outocmes or why not use computerised/ tablet/phone-based outcomes would allow you make distance assessments without having to travel to your neurologist.
But why would you want to travel to your neurologist if all you get is sorry we can’t do anything, surely there has to be a better way than this.