Home-based training to improve manual dexterity in patients with multiple sclerosis: A randomized controlled trial.

Kamm, Christian Philipp; Mattle, Heinrich P.; Müri, René Martin; Heldner, Mirjam Rachel; Blatter Arifi, Verena; Bartlome, Sandrine; Lüthy, Judith; Imboden, Debora; Pedrazzini, Giovanna Rachele Marilyn; Bohlhalter, Stephan; Hilfiker, Roger; Vanbellingen, Tim (2015). Home-based training to improve manual dexterity in patients with multiple sclerosis: A randomized controlled trial. Multiple sclerosis journal, 21(12), pp. 1546-1556. Sage 10.1177/1352458514565959

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BACKGROUND

Impaired manual dexterity is frequent and disabling in patients with multiple sclerosis (MS), affecting activities of daily living (ADL) and quality of life.

OBJECTIVE

We aimed to evaluate the effectiveness of a standardized, home-based training program to improve manual dexterity and dexterity-related ADL in MS patients.

METHODS

This was a randomized, rater-blinded controlled trial. Thirty-nine MS patients acknowledging impaired manual dexterity and having a pathological Coin Rotation Task (CRT), Nine Hole Peg Test (9HPT) or both were randomized 1:1 into two standardized training programs, the dexterity training program and the theraband training program. Patients trained five days per week in both programs over a period of 4 weeks. Primary outcome measures performed at baseline and after 4 weeks were the CRT, 9HPT and a dexterous-related ADL questionnaire. Secondary outcome measures were the Chedoke Arm and Hand Activity Inventory (CAHAI-8) and the JAMAR test.

RESULTS

The dexterity training program resulted in significant improvements in almost all outcome measures at study end compared with baseline. The theraband training program resulted in mostly non-significant improvements.

CONCLUSION

The home-based dexterity training program significantly improved manual dexterity and dexterity-related ADL in moderately disabled MS patients. Trial Registration NCT01507636.

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