title: The relationship between walking, manual dexterity, cognition and activity/participation in persons with multiple sclerosis.
abstract: BACKGROUND
  Multiple sclerosis has a vast impact on health, but the relationship between walking, manual dexterity, cognition and activity/participation is unclear.
  
  
  OBJECTIVE
  The specific aims were to explore the discriminative ability of measures of walking, manual dexterity and cognition, and to identify cut-off values in these measures, for prediction of independence in personal and instrumental activities of daily living (ADL) and activity/participation in social and lifestyle activities.
  
  
  METHODS
  Data from 164 persons with multiple sclerosis were collected during home visits with the following measures: the 2 × 5 m walk test, the Nine-hole Peg Test, the Symbol Digit Modalities Test, the Katz Personal and Instrumental ADL Indexes, and the Frenchay Activities Index (measuring frequency in social and lifestyle activities).
  
  
  RESULTS
  The 2 × 5 m walk test and the Nine-hole Peg Test had high and better discriminative and predictive ability than the Symbol Digit Modalities Test. Cut-off values were identified. The accuracy of predictions was increased above all by combining the 2 × 5 m walk test and the Nine-hole Peg Test.
  
  
  CONCLUSIONS
  The proposed cut-off values in the 2 × 5 m walk test and the Nine-hole Peg Test may be used as indicators of functioning and to identify persons risking activity limitations and participation restrictions. However, further studies are needed to confirm the usefulness in clinical practice.
authors: Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Stockholm, Sweden. marie.kierkegaard@karolinska.se
authors: Marie
authors: M
authors: Kierkegaard
authors: Ulrika
authors: U
authors: Einarsson
authors: Kristina
authors: K
authors: Gottberg
authors: Lena
authors: L
authors: von Koch
authors: Lotta Widén
authors: LW
authors: Holmqvist
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D003071:Cognition; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D005080:Exercise Test; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D008019:Life Style; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009048:Motor Skills; D009103:Multiple Sclerosis / Q000175:diagnosis* / Q000503:physiopathology / Q000523:psychology; D009483:Neuropsychological Tests; D011237:Predictive Value of Tests; D011379:Prognosis; D012042:Registries; D012720:Severity of Illness Index; D058992:Social Participation; D011795:Surveys and Questionnaires; D013548:Sweden; D016138:Walking; D055815:Young Adult