title: Innovative methods to assess upper limb strength and function in non-ambulant Duchenne patients.
abstract: Upper limb assessment in non-ambulant patients remains a challenge. We have designed new tools to precisely assess pinch (MyoPinch), grip (MyoGrip), wrist flexion and extension (MyoWrist) strength. We have also designed a new tool to assess the ability of patients to produce repetitive flexion/extension movements of wrist and fingers (MoviPlate). We have assessed the feasibility and reliability of these new tools in 30 non-ambulant patients with Duchenne muscular dystrophy and in 30 age-matched male controls. Existing measures, such as Motor Function Measure, Tapping, and the Brooke Upper Extremity Functional Rating Scale were also performed. Results demonstrated that assessments were feasible in nearly all upper limbs tested for MyoGrip, MyoPinch and MoviPlate. The reliability of all tests, including MyoWrist which was not feasible in the patients presenting with contractures, was excellent in patients as in controls. Motor capacities decrease with the number of months spent in the wheelchair. The scores in the tests were partially correlated with each other, and with clinical measures such as vital capacity, Motor Function Measure, functional hand scale and Brooke score. This study validates a panel of upper limb muscle strength and function measures for Duchenne Muscular Dystrophy which can be applied from controls to extremely weak patients.
authors.affiliation: Institute of Myology, AP-HP, Groupe hospitalier La Pitié Salpétrière, Paris, France. l.servais@institut-myologie.org
authors.forename: L
authors.initials: L
authors.lastname: Servais
authors.forename: N
authors.initials: N
authors.lastname: Deconinck
authors.forename: A
authors.initials: A
authors.lastname: Moraux
authors.forename: M
authors.initials: M
authors.lastname: Benali
authors.forename: A
authors.initials: A
authors.lastname: Canal
authors.forename: F
authors.initials: F
authors.lastname: Van Parys
authors.forename: W
authors.initials: W
authors.lastname: Vereecke
authors.forename: S
authors.initials: S
authors.lastname: Wittevrongel
authors.forename: M
authors.initials: M
authors.lastname: Mayer
authors.forename: I
authors.initials: I
authors.lastname: Desguerre
authors.forename: K
authors.initials: K
authors.lastname: Maincent
authors.forename: C
authors.initials: C
authors.lastname: Themar-Noel
authors.forename: S
authors.initials: S
authors.lastname: Quijano-Roy
authors.forename: N
authors.initials: N
authors.lastname: Serari
authors.forename: T
authors.initials: T
authors.lastname: Voit
authors.forename: J-Y
authors.initials: JY
authors.lastname: Hogrel
mesh_terms: D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D002648:Child; D003955:Diagnostic Tests, Routine / Q000379:methods*; D005240:Feasibility Studies; D018737:Hand Strength / Q000502:physiology; D006801:Humans; D008297:Male; D053580:Muscle Strength / Q000502:physiology*; D018482:Muscle, Skeletal / Q000503:physiopathology*; D020388:Muscular Dystrophy, Duchenne / Q000175:diagnosis* / Q000503:physiopathology*; D017063:Outcome Assessment, Health Care; D016059:Range of Motion, Articular / Q000502:physiology; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D034941:Upper Extremity / Q000503:physiopathology*; D014955:Wrist Joint / Q000503:physiopathology; D055815:Young Adult