Department of Neurology, 12297NYU Grossman School of Medicine, New York, NY, USA.
St. Elizabeth's Department of Behavioral Health, Elizabeth, NJ, USA.
J Child Neurol. 2021 Aug;36(9):720-726. doi: 10.1177/0883073821999889. Epub 2021 Mar 19.
To adopt a computer-based protocol to assess grip fatigability in patients with pediatric-onset multiple sclerosis to provide detection of subtle motor involvement identifying those patients most at risk for future decline.
Pediatric-onset multiple sclerosis patients were recruited during routine outpatient visits to complete a grip assessment and compared to a group of healthy age- and sex-matched controls. All participants completed a computer-based measurement of standard maximal grip strength and repetitive and sustained grip performance measured by dynamic and static fatigue indices.
A total of 38 patients with pediatric-onset multiple sclerosis and 24 healthy controls completed the grip protocol (right-hand dominant). There were no significant group differences in maximal grip strength bilaterally (right: 21.8 vs 19.9 kg, = .25; left: 20.4 vs 18.7 kg, = .33), although males with pediatric-onset multiple sclerosis were significantly less strong than healthy controls (right: 26.53 vs 21.23 kg, = .009; left; 25.13 vs 19.63 kg, = .003). Both dynamic and static fatigue indices were significantly higher bilaterally in pediatric-onset multiple sclerosis compared with healthy control participants (left-hand dynamic fatigue index: 18.6% vs 26.7%, = .003; right-hand static fatigue index: 28.3% vs 41.3%, < .001; left-hand static fatigue index: 31.9% vs 42.6%, < .001).
Brief repeatable grip assessment including measures of dynamic and sustained static output can be a sensitive indicator of upper extremity motor involvement in pediatric-onset multiple sclerosis, potentially identifying those in need of intervention to prevent future disability.
采用基于计算机的方案来评估儿科发病多发性硬化症患者的握力疲劳性，以发现细微的运动障碍，从而确定那些未来功能下降风险较高的患者。
在常规门诊就诊期间招募儿科发病多发性硬化症患者，让其完成握力评估，并与一组年龄和性别匹配的健康对照组进行比较。所有参与者均完成了标准最大握力的计算机测量，以及通过动态和静态疲劳指数测量的重复性和持续性握力表现。
共有 38 名儿科发病多发性硬化症患者和 24 名健康对照组（右利手）完成了握力方案。双侧最大握力在组间无显著差异（右侧：21.8 与 19.9 kg， =.25；左侧：20.4 与 18.7 kg， =.33），但儿科发病多发性硬化症男性患者的握力明显弱于健康对照组（右侧：26.53 与 21.23 kg， =.009；左侧：25.13 与 19.63 kg， =.003）。与健康对照组参与者相比，双侧的动态和静态疲劳指数在儿科发病多发性硬化症患者中均显著升高（左手动态疲劳指数：18.6%与 26.7%， =.003；右手静态疲劳指数：28.3%与 41.3%， <.001；左手静态疲劳指数：31.9%与 42.6%， <.001）。
简短、可重复的握力评估，包括动态和持续性静态输出的测量，可能成为儿科发病多发性硬化症患者上肢运动障碍的敏感指标，有助于识别需要干预以预防未来残疾的患者。
