In Multiple Sclerosis, Hand Strength May Indicate Disease Status

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Grip strength may be an additional sensitive measure of MS disease progression.
Grip strength may be an additional sensitive measure of MS disease progression.

Hand function, which is strongly correlated with quality-of-life measures in multiple sclerosis (MS), may be a sensitive component for monitoring disease progression over time, according to findings presented at the 2017 Consortium of Multiple Sclerosis Centers Annual Meeting, May 24-27 in New Orleans.

In order to quantify changes in grip strength and determine if those changes correlate with other measures of MS disease status, including the Timed 25-foot Walk and Expanded Disability Status Scale (EDSS) score, a team of researchers led by Meghan C. Romba, MD, of Johns Hopkins Hospital in Baltimore, Maryland, conducted a longitudinal study of hand grip strength in 61 patients with MS.

The patients (relapsing-remitting MS [n=37] and secondary progressive MS [n=24]) had EDSS scores from 0 to 8.5 and were followed for an average of 5 years. Bilateral grip strength was evaluated annually using dynamometry; EDSS and Timed 25-Foot Walk test were also administered.

The investigators found that both weaker and dominant hand grip strength was significantly correlated with slower Timed 25-Foot Walk time (for weaker hand: r = 0.39; P <.0001; for dominant hand: r = 0.29; P <.0001). After adjusting for age, MS disease subtype, symptom duration, and sex, a marginally significant annual decline in weaker (–0.68 lb [95% CI, –1.41-0.05; P =.07) and dominant hand grip function (–0.78 lb [95% CI, –1.56-0.13; P =.09) was observed. Notably, a marginally significant stronger rate of decline was observed in the dominant hand of patients with progressive MS (P =.05).

Ultimately, monitoring hand strength with a dynamometer may be an objective and sensitive measure to add to MS disease status assessments. Further studies are required to assess hand grip strength as a clinical outcome and establish a clinically important change.

Reference

Romba MC, Fitzgerald K, Baynes M, Calabresi PA, Zackowski KM. A five-year study evaluating hand grip strength as an assessment tool for multiple sclerosis disease progression. Presented at: 2017 Consortium of Multiple Sclerosis Centers Annual Meeting. May 24-27, 2017; New Orleans, LA. Abstract QL17. 

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