| Autor: |
Rammohan, Kottil, Li, David, Halper, June, McCurdy Murphy, Sara, Wallace, Trent, Patton, Lisa, Chrisant, Sarah, Chao Zheng, Khurana, Seema |
| Předmět: |
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| Zdroj: |
International Journal of MS Care; 2020, Vol. 22 Issue S2, p45-45, 1/3p |
| Abstrakt: |
Background: The North American Registry for Care and Research in Multiple Sclerosis (NARCRMS) is a longitudinal registry studying the course of multiple sclerosis (MS) in the disease-modifying era. Objectives: To examine motor performance metrics of upper and lower extremity function in NARCRMS patients at enrollment. Methods: Recruitment began in 2016, and by December 31, 2019, 662 patients were enrolled at 23 MS sites across the United States and Canada. People with any subtype of MS within 15 years of disease onset and an Expanded Disability Status Scale (EDSS) score of up to 6.5 are eligible for enrollment. Various clinical metrics are collected including motor performance for upper and lower extremities. Our initial observations about EDSS, 25-foot timed walk, and the Nine-Hole Peg Test (NHPT) are reported below. Results: EDSS scores and 25-foot walk times were available in 579 patients and upper extremity function in 571 patients. A mean walking speed of 4.9 seconds was recorded in patients with an EDSS score of 0 (n = 100). 5.0 seconds remained the mean speed until an EDSS score of 3.0 (n = 37), where a mean speed of 5.6 seconds was recorded. Walking truly became affected at an EDSS score of 3.5 (n = 25), where a mean speed of 6.1 seconds was recorded. Thereafter, mean speed progressively declined at every EDSS score increase. For an EDSS score of 4.0 (n = 25), mean speed was 7.9 seconds; for an EDSS score of 4.5 (n = 6), mean speed was 9.1 seconds and continued to increase until an EDSS score of 6.5 (n = 10), where mean speed was 16.8 seconds. For the NHPT, patients with an EDSS score of 0 (n = 96) had a mean speed of 19.4 seconds in the dominant and 20.7 seconds in the nondominant hand. Hand function remained unimpaired until an EDSS score of 2.0, and significant slowing occurred in patients with EDSS scores ranging from 2.5 to 6.5. For an EDSS score of 2.5 (n = 40), mean speed was 24.7 seconds in the dominant and 24 seconds in the nondominant hand. For an EDSS score of 4.0 (n = 26), mean speed was 26.1 seconds in the dominant and 26.6 seconds in the nondominant hand. For an EDSS score of 6.5 (n = 15), hand function had declined to a mean speed of 39.1 seconds for the dominant and 49.8 seconds for the nondominant hand. Conclusions: A linear correlation of the 25-foot walk speed to EDSS score increases was remarkable, reiterating the commonly held belief that the EDSS is a "walking scale." Decline in hand function at an EDSS score of 2.5 was unexpected, because hands are often perceived to be unaffected early in MS and seldom observed as impaired by patients. Progressive decline of hand function at every EDSS score increase would suggest that the NHPT test is a good marker of declining hand function and should be included in clinical monitoring of patients. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
| Externí odkaz: |
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