In Multiple Sclerosis, Hand Strength May Indicate Disease Status

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.