Evaluation of upper extremity ataxia through image processing in individuals with multiple sclerosis

ABSTRACT

Background: Impaired dexterity is a frequently reported disability among people with ataxic multiple sclerosis (MS). Objective: To quantify and standardize the evaluation of upper extremity coordination disorder among patients with multiple sclerosis (MS), using the Tablet Ataxia Assessment Program (TAAP). Methods: The X and Y axis movements of 50 MS patients and 30 healthy individuals who were evaluated using the International Cooperative Ataxia Rating Scale (ICARS) were also assessed using TAAP. The functional times of the participants’ right and left hands were recorded using the nine-hole peg test (NHPT). The upper extremity coordination of individuals with MS was evaluated using the upper extremity kinetic functions section of ICARS. Results: The deviations for the X and Y axis movements of the MS group were greater than those of the control group (p<0.05). Significant correlations were shown between TAAP scores and NHPT and ICARS scores. The strongest correlation was found between NHPT and ICARS in the dominant hand (r_nhpt=0.356, p_nhpt=0.001; r_icars=0.439, p_icars=0.000). In correlating the Y axis with ICARS, the deviations in the Y axis were found to be greater in the non-dominant hand than those in the X axis (r_yright=0.402, p_yright=0.004; r_yleft=0.691, p_yleft=0.000).

Conclusion: Measurement using TAAP is more sensitive than other classical and current methods for evaluating ataxia. We think that TAAP is an objective tool that will allow neurorehabilitation professionals and clinicians to evaluate upper extremity coordination.

RESUMO

Antecedentes: Destreza prejudicada é uma deficiência frequentemente relatada em pessoas com esclerose múltipla (EM) atáxica. Objetivo: Nosso objetivo é quantificar e padronizar a avaliação do distúrbio de coordenação da extremidade superior em pacientes com EM usando o Tablet Ataxia Assessment Program (TAAP). Métodos: Os movimentos dos eixos X e Y de 50 EM e 30 indivíduos saudáveis que foram avaliados com a International Cooperative Ataxia Rating Scale (ICARS) também foram avaliados com TAAP. Os tempos funcionais das mãos direita e esquerda dos participantes foram registrados usando o teste de nove pinos (NHPT). A coordenação da extremidade superior de indivíduos com EM foi avaliada com a seção de funções cinéticas da extremidade superior do ICARS. Resultados: Os desvios para os movimentos dos eixos X e Y do grupo MS foram maiores do que os do grupo controle (p <0,05). Correlações significativas foram mostradas entre os escores do TAAP e os escores do NHPT e do ICARS. A correlação mais forte foi encontrada entre NHPT e ICARS na mão dominante (r_nhpt=0,356, p_nhpt=0,001, r_icars=0,439 e p_icars=0,000). Na correlação do eixo Y com ICARS, observou-se que os desvios no eixo Y foram maiores na mão não dominante do que no eixo X (r_yright=0,402, p_yright=0,004, r_yleft=0,691 e p_yleft=0,000). Conclusão: A medição com TAAP é mais sensível do que outros métodos clássicos e atuais de avaliação de ataxia. Acreditamos que o TAAP seja uma ferramenta objetiva que permitirá aos profissionais de neurorreabilitação e médicos avaliar a coordenação dos membros superiores.

Keywords:

Multiple Sclerosis - Ataxia - Upper Extremity - Diagnosis

Palavras-chave:

Esclerose Múltipla - Ataxia - Extremidade Superior - Diagnóstico

Authors’ contributions:

FE: study design, data analysis; IY: interpretation of sensor data, patient recruitment and evaluation; AUU: drafting the work or revising it critically for important intellectual content; MA: interpretation of data for study, drafting the work or revising it critically for important intellectual content.

Publikationsverlauf

Eingereicht: 22. Januar 2021

Angenommen: 11. April 2021

Artikel online veröffentlicht:
31. Januar 2023

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