Article

OBJECTIVES: To determine the effects of multiple sclerosis (MS) on predictive and
reactive grip force control in a catching task and on clinical tests of hand
function. DESIGN: Case-control study with matched-pairs control group. SETTING:
University prevention and rehabilitation center. PARTICIPANTS: Participants
(N=30) consisted of people with multiple sclerosis (PwMS) (n=15) and healthy
controls (n=15), matched for sex, age, and hand dominance. INTERVENTIONS: Not
applicable. MAIN OUTCOME MEASURES: Performance on the Expanded Disability Status
Scale (EDSS), Nine-Hole Peg Test (9-HPT), Jebsen-Taylor Hand Function Test
(JTHFT), and 2-point discrimination (2PD) was evaluated. To analyze grip force
control, blindfolded subjects held a receptacle equipped with grip force and
acceleration sensors in their hand. In a catching task, a weight was dropped from
(1) the experimenter's hand unexpectedly into the receptacle (reactive force
control); and (2) from the subject's opposite hand (predictive force control).
Grip forces and time lags were analyzed. RESULTS: PwMS (mean EDSS +/- SD,
4.2+/-1.86) had impairments in the 9-HPT and JTHFT (P<.001). The 2PD did not
differ significantly between PwMS and controls. During reactive force control
(catching task 1), PwMS showed significantly higher grip forces immediately after
impact (P<.05), and a significant prolongation of the time from grip force
increase until reaching the peak of grip force (P<.001). PwMS and controls did
not differ during predictive force control (catching task 2; P>.1). CONCLUSIONS:
Exaggerated grip force responses and alterations of timing after an unpredictable
perturbation, combined with preserved grip force control during predictable
conditions, is a characteristic pattern of fine motor control deficits in MS.
Measures of reactive grip force responses may be used to complement neurologic
assessments. Further studies exploring the usefulness of these measures should be
performed in a broader community of PwMS.
CI - Copyright (c) 2016 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS