title: Limb apraxia in multiple sclerosis: prevalence and impact on manual dexterity and activities of daily living.
abstract: OBJECTIVE
  To evaluate the prevalence and impact of limb apraxia on manual dexterity and activities of daily living (ADLs) in patients with multiple sclerosis (MS).
  
  
  METHODS
  Survey.
  
  
  METHODS
  University hospital.
  
  
  METHODS
  Consecutive patients (N=76) with clinically isolated syndrome, relapsing-remitting multiple sclerosis (RRMS), secondary progressive multiple sclerosis (SPMS) or primary progressive multiple sclerosis (PPMS), Expanded Disability Status Scale (EDSS) score from 0 to 6.5, and aged from 18 to 70 years were included.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  Apraxia was assessed by the apraxia screen of TULIA (AST). The relationship of apraxia with ADLs and manual dexterity was evaluated using a dexterity questionnaire and the coin rotation task, respectively.
  
  
  RESULTS
  Overall, limb apraxia was found in 26.3% of patients (mean AST score ± SD, 7.3±1.3; cutoff <9). Apraxia was significantly correlated with higher EDSS scores, longer disease duration, and higher age with the EDSS being predictive. Furthermore, patients with SPMS and PPMS were more apraxic than patients with RRMS. Finally, limb apraxia was significantly associated with impaired ADLs and manual dexterity.
  
  
  CONCLUSIONS
  Limb apraxia is a frequent and clinically significant symptom contributing to disability in MS. It should therefore be evaluated and possibly treated, particularly in patients with MS reporting manual difficulties in everyday life.
authors.affiliation: Department of Neurology, Inselspital, Bern University Hospital, Bern, Switzerland.
authors.forename: Christian P
authors.initials: CP
authors.lastname: Kamm
authors.forename: Mirjam R
authors.initials: MR
authors.lastname: Heldner
authors.forename: Tim
authors.initials: T
authors.lastname: Vanbellingen
authors.forename: Heinrich P
authors.initials: HP
authors.lastname: Mattle
authors.forename: René
authors.initials: R
authors.lastname: Müri
authors.forename: Stephan
authors.initials: S
authors.lastname: Bohlhalter
mesh_terms: D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000704:Analysis of Variance; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D005260:Female; D007839:Functional Laterality / Q000502:physiology*; D020235:Gait Apraxia / Q000175:diagnosis / Q000453:epidemiology* / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000175:diagnosis / Q000453:epidemiology / Q000534:rehabilitation; D020528:Multiple Sclerosis, Chronic Progressive / Q000175:diagnosis / Q000453:epidemiology* / Q000534:rehabilitation*; D015995:Prevalence; D011379:Prognosis; D012044:Regression Analysis; D018570:Risk Assessment; D017678:Sex Distribution; D018709:Statistics, Nonparametric; D016896:Treatment Outcome; D055815:Young Adult