title: Coin rotation task: a valid test for manual dexterity in multiple sclerosis.
abstract: BACKGROUND
  Impaired manual dexterity is frequent and disabling in people with multiple sclerosis (MS). Therefore, convenient, quick, and validated tests for manual dexterity in people with MS are needed.
  
  
  OBJECTIVE
  The aim of this study was to validate the Coin Rotation Task (CRT) for examining manual dexterity in people with MS.
  
  
  METHODS
  This was a cross-sectional study.
  
  
  METHODS
  A total of 101 outpatients with MS were assessed with the CRT, the Expanded Disability Status Scale (EDSS), the Scale for the Assessment and Rating of Ataxia (SARA), and the Modified Ashworth Scale (MAS); muscle strength and sensory deficits of the hands were noted. The concurrent validity and diagnostic accuracy of the CRT were determined by comparison with the 9-Hole Peg Test (9HPT). Construct validity was determined by comparison with a valid dexterity questionnaire. Multiple regression analyses were done to explore correlations of the CRT with the EDSS, SARA, MAS, muscle strength, and sensory deficits.
  
  
  RESULTS
  The CRT correlated significantly with the 9HPT (r=.73, P<.0001), indicating good concurrent validity. The cutoff values for the CRT relative to the 9HPT were 18.75 seconds for the dominant hand (sensitivity=81.5%, specificity=80.0%) and 19.25 seconds for the nondominant hand (sensitivity=90.3%, specificity=81.8%); these values indicated good diagnostic accuracy. Furthermore, the CRT correlated significantly with the dexterity questionnaire (r=-.49, P<.0001), indicating moderate construct validity. Multiple regression analyses revealed that the EDSS was the strongest predictor for impaired dexterity.
  
  
  CONCLUSIONS
  Most of the people examined had relapsing-remitting MS and EDSS scores of up to 7.
  
  
  CONCLUSIONS
  This study validated the CRT as a test that can be used easily and quickly to evaluate manual dexterity in people with MS.
authors.affiliation: M.R. Heldner, MD, Department of Neurology, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland. Dr Heldner and Dr Vanbellingen contributed equally to the article.
authors.forename: Mirjam R
authors.initials: MR
authors.lastname: Heldner
authors.affiliation: T. Vanbellingen, PhD, Perception and Eye Movement Laboratory, Departments of Neurology and Clinical Research, Inselspital, Bern University Hospital, and University of Bern. Dr Heldner and Dr Vanbellingen contributed equally to the article.
authors.forename: Tim
authors.initials: T
authors.lastname: Vanbellingen
authors.affiliation: S. Bohlhalter, MD, Neurology and Neurorehabilitation Center, Department of Internal Medicine, Luzerner Kantonsspital, Lucerne, Switzerland.
authors.forename: Stephan
authors.initials: S
authors.lastname: Bohlhalter
authors.affiliation: H.P. Mattle, MD, Department of Neurology, Inselspital, Bern University Hospital, and University of Bern.
authors.forename: Heinrich P
authors.initials: HP
authors.lastname: Mattle
authors.affiliation: R.M. Müri, MD, Perception and Eye Movement Laboratory, Departments of Neurology and Clinical Research, Inselspital, Bern University Hospital, and University of Bern.
authors.forename: René M
authors.initials: RM
authors.lastname: Müri
authors.affiliation: C.P. Kamm, MD, Department of Neurology, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland. christian.kamm@insel.ch.
authors.forename: Christian P
authors.initials: CP
authors.lastname: Kamm
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D005260:Female; D007839:Functional Laterality / Q000502:physiology*; D018737:Hand Strength / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009048:Motor Skills / Q000502:physiology*; D009103:Multiple Sclerosis / Q000150:complications* / Q000503:physiopathology*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014110:Touch / Q000502:physiology; D055815:Young Adult