Research: hand and arm strength in MS

Guclu-Gunduz et al. Upper extremity function and its relation with hand sensation and upper extremity strength in patients with multiple sclerosis.NeuroRehabilitation. 2012 ;30(4):369-74.

Objective: The purpose of this study was to investigate the relationships between the upper extremity functions, upper extremity strength and hand sensation in MSers. 

Methods: 22 MSers (mean age: 38.5 ± 8.31 years, median EDSS = 2) and 10 healthy subjects were included. Upper extremity function was measured with the 9-hole peg test, upper extremity strength (shoulder flexion-abduction, elbow flexion, pinch and grip) with hand-held dynamometer (strength meter), hand grip dynamometer and manual pinch meter, threshold of light touch-pressure with Semmes-Weinstein monofilament, duration of vibration with 128-Hz frequency tuning fork, and distance of two-point discrimination with an aesthesiometer. 

Results: Strength and functional level of the upper extremity, light touch-pressure, two-point discrimination, vibration sensations of the hand were lower in MSers compared with healthy controls (p < 0.05). Light touch-pressure sensation of thumb and index fingers, two-point discrimination of index finger and elbow flexion strength were found to be related with upper extremity function in MSers (p< 0.05). 
Handgrip Dynamometer
Conclusions: These results indicate that the hand sensation, upper extremity strength and function were affected in MSers. Additionally upper extremity functions seem to be related with light touch-pressure and two-point discrimination sensations of the hand and elbow flexion strength. Upper extremity strengthening and sensorial training of the hand may contribute to the upper extremity function in MSers.

"These results show that even in MSers with early disease, i.e. minimal disability with an EDSS of 2.0, there is involvement of the upper limbs. Most MSers would not notice this disability as it is very mild and would only show up with sensitive tests. Another cause of some of these abnormalities is de-conditioning that occurs as a result of becoming 'relatively inactive'."

"Are you aware of any upper limb problems?"

Semmes-Weinstein monofilament Test

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