Mam36 and Abilhand as outcome measures of multiple sclerosis hand disability: an observational study

BACKGROUND: Impaired upper limb functionality and dexterity are common in people with multiple sclerosis (PwMS) and lead to increased dependency and reduced quality of life. AIM OF THE STUDY: To Compare the ability of the Manual Abilites Measure 36 (MAM-36) and the Abilhand questionnaire to recognize an involvement of the upper limbs in PwMS, and to compare their results with those of other patient reported outcomes (PRO) evaluating disability, functional independence, symptoms of anxiety and depression, fatigue and quality of life. DESIGN: Observational study. SETTING: Outpatient. POPULATION: 51 PwMS (mean age 56,31 years, age range 33-82 years, 72,5% females). METHODS: For each patient were collected MAM-36, Abilhand questionnaire, expanded disability status scale (EDSS), Functional Independence measure (FIM), Hospital Anxiety and Depression Scale (HADS), Modified Fatigue Impact Scale (MFIS) and Life Satisfaction Index (LSI). RESULTS: A strong correlation between MAM-36 and the Abilhand questionnaire (Spearman r: 0.79; p<0.0001) were found. We obtained a significant correlation between MAM-36 and EDSS (Spearman r: -0.5; p= 0.0002), FIM (Spearman r: 0.55; p<0.0001); we did not observe a correlation with MFIS (Spearman r: -0.33; p: 0.02); moreover we found a similar trend between Abilhand and EDSS (Spearman r: -0.47; p= 0.0005), FIM (Spearman r: 0.61; p<0.0001), MFIS (Spearman r: -0.41; p: 0.002). CONCLUSIONS: In PwMS the assessment of upper limbs is fundamental since it closely related to the level of disability of the person. Both MAM-36 and Abilhand Questionnaire are equally able to detect upper limb dysfunctions in PwMS. CLINICAL REHABILITATION IMPACT: Both MAM-36 and Abilhand can be used for upper limbs evaluation, within a multidimensional approach that seems to be the best way to evaluate PwMS.