Highlights
- •Upper limb impairment affects over 60% of individuals.
- •Upper limb impairment adversely affects employment and the ability to perform daily activities.
- •Seeing an occupational therapist was associated with using assistive devices to aid function.
Abstract
Background
Individuals with multiple sclerosis (MS) frequently suffer from impaired sensory function,
reduced strength and tremor in the upper limbs, which may interfere with upper limb
function. However, upper limb impairment in MS is under-recognized and understudied.
We aimed to evaluate the prevalence of upper limb impairment in a large sample of
persons with MS; the association between upper limb function and employment status
in MS; and the frequency of use of assistive devices aimed at addressing upper limb
impairments.
Methods
We surveyed participants in the North American Research Committee on Multiple Sclerosis
(NARCOMS) Registry regarding upper limb function using the ABILHAND questionnaire,
and asked about use of assistive devices intended to improve the performance on upper
limb activities. We evaluated the association between ABILHAND scores and current
employment status using multivariable logistic regression analysis, and the association
between ABILHAND scores and the use of an assistive device.
Results
Of 7463 eligible respondents, 5846 (78.3%) were female and mean (SD) age of 57.4 (10.2)
years. The median (IQR) score on the ABILHAND was 45 (39–46). Higher levels of disability,
as measured by the PDDS, correlated moderately with lower (worse) scores on the ABILHAND
(r=−0.50; 95%CI: −0.48, −0.52). Over half of participants reported that they possessed
an assistive device to aid upper limb function (3914, 56.0%). Older age, female sex,
greater ambulatory disability, higher levels of fatigue, sensory impairment, spasticity
and cognitive impairment, and visiting an occupational therapist were independently
associated with increased odds of using an assistive device. After accounting for
disability, perceived cognitive impairment, and fatigue, impaired upper limb function
was associated with decreased odds of being employed (OR/1 point rise in ABILHAND
0.97; 95%CI: 0.96, 0.98).
Conclusions
Upper limb impairment is common in older MS patients, and adversely affects the ability
to perform many common daily activities.
Keywords
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Article info
Publication history
Published online: February 18, 2017
Accepted:
February 17,
2017
Received in revised form:
February 10,
2017
Received:
December 10,
2016
Identification
Copyright
© 2017 Elsevier B.V. All rights reserved.
