Box and Block Test, Hand Grip Strength, and 9-Hole Peg Test: Correlations between Three Upper Limb Objective Measures in Multiple Sclerosis.

INTRODUCTION: Limited data are available in literature for upper limb (UL) impairment in multiple sclerosis (MS). This study aims to report the distribution of values of Hand Grip Strength (HGS), of Box-and-Block Test (BBT) and of 9-Hole Peg Test (9HPT), correlated with demographic and clinical data in subjects with MS.

MATERIALS AND METHODS: This study involved 5 Italian neurological centers.

INCLUSION CRITERIA: age ≥18, MS diagnosis, stable disease phase, right hand dominance. All subjects underwent HGS, BBT and 9-HPT evaluation.

RESULTS: 202 subjects with MS were enrolled: 137 females; mean age 48.4 years; mean EDSS 4.17; mean disease duration 14.12 years; disease course was 129 RR, 21 PPMS and 52 SPMS subjects. Mean right HGS 25.3 Kg, left 23.2 Kg; mean right BBT 45.7 blocks, left 44.9 blocks; mean right 9-HPT 30.7 seconds, left 33.4 seconds. All results were statistically significantly different compared to healthy controls. HGS, BBT and 9-HPT were associated with age, EDSS and disease duration, while disease course correlated with BBT and 9-HPT. BBT and 9-HPT scores significantly differed according to level of disability (EDSS <3.5, 3.5-5.5, >5.5).

CONCLUSION: HGS and BBT value distribution in a large MS population are reported. Correlations between HGS and BBT and 9-HPT were generally low.