title: Home-based training to improve manual dexterity in patients with multiple sclerosis: A randomized controlled trial.
abstract: BACKGROUND
  Impaired manual dexterity is frequent and disabling in patients with multiple sclerosis (MS), affecting activities of daily living (ADL) and quality of life.
  
  
  OBJECTIVE
  We aimed to evaluate the effectiveness of a standardized, home-based training program to improve manual dexterity and dexterity-related ADL in MS patients.
  
  
  METHODS
  This was a randomized, rater-blinded controlled trial. Thirty-nine MS patients acknowledging impaired manual dexterity and having a pathological Coin Rotation Task (CRT), Nine Hole Peg Test (9HPT) or both were randomized 1:1 into two standardized training programs, the dexterity training program and the theraband training program. Patients trained five days per week in both programs over a period of 4 weeks. Primary outcome measures performed at baseline and after 4 weeks were the CRT, 9HPT and a dexterous-related ADL questionnaire. Secondary outcome measures were the Chedoke Arm and Hand Activity Inventory (CAHAI-8) and the JAMAR test.
  
  
  RESULTS
  The dexterity training program resulted in significant improvements in almost all outcome measures at study end compared with baseline. The theraband training program resulted in mostly non-significant improvements.
  
  
  CONCLUSIONS
  The home-based dexterity training program significantly improved manual dexterity and dexterity-related ADL in moderately disabled MS patients. Trial Registration NCT01507636.
authors.affiliation: Department of Neurology, Inselspital, Bern University Hospital, and University of Bern, Switzerland christian.kamm@insel.ch.
authors.forename: Christian P
authors.initials: CP
authors.lastname: Kamm
authors.affiliation: Department of Neurology, Inselspital, Bern University Hospital, and University of Bern, Switzerland.
authors.forename: Heinrich P
authors.initials: HP
authors.lastname: Mattle
authors.affiliation: Division of Cognitive and Restorative Neurology, Department of Neurology, Inselspital, Bern University Hospital, and University of Bern, Switzerland.
authors.forename: René M
authors.initials: RM
authors.lastname: Müri
authors.affiliation: Department of Neurology, Inselspital, Bern University Hospital, and University of Bern, Switzerland.
authors.forename: Mirjam R
authors.initials: MR
authors.lastname: Heldner
authors.affiliation: Department of Neurology, Inselspital, Bern University Hospital, and University of Bern, Switzerland.
authors.forename: Verena
authors.initials: V
authors.lastname: Blatter
authors.affiliation: Division of Cognitive and Restorative Neurology, Department of Neurology, Inselspital, Bern University Hospital, and University of Bern, Switzerland.
authors.forename: Sandrine
authors.initials: S
authors.lastname: Bartlome
authors.affiliation: Division of Cognitive and Restorative Neurology, Department of Neurology, Inselspital, Bern University Hospital, and University of Bern, Switzerland.
authors.forename: Judith
authors.initials: J
authors.lastname: Lüthy
authors.affiliation: Division of Cognitive and Restorative Neurology, Department of Neurology, Inselspital, Bern University Hospital, and University of Bern, Switzerland.
authors.forename: Debora
authors.initials: D
authors.lastname: Imboden
authors.affiliation: Department of Neurology, Inselspital, Bern University Hospital, and University of Bern, Switzerland.
authors.forename: Giovanna
authors.initials: G
authors.lastname: Pedrazzini
authors.affiliation: Neurology and Neurorehabilitation Center, Luzerner Kantonsspital, Switzerland.
authors.forename: Stephan
authors.initials: S
authors.lastname: Bohlhalter
authors.affiliation: HES-SO Valais-Wallis, School of Health Sciences, University of Applied Sciences and Arts Western Switzerland Valais, Sion, Switzerland.
authors.forename: Roger
authors.initials: R
authors.lastname: Hilfiker
authors.affiliation: Department of Neurology, Inselspital, Bern University Hospital, and University of Bern, Switzerland/Neurology and Neurorehabilitation Center, Luzerner Kantonsspital, Switzerland.
authors.forename: Tim
authors.initials: T
authors.lastname: Vanbellingen
mesh_terms: D000328:Adult; D005260:Female; D006225:Hand / Q000503:physiopathology*; D006699:Home Care Services; D006801:Humans; D008297:Male; D008875:Middle Aged; D009048:Motor Skills / Q000502:physiology*; D009103:Multiple Sclerosis / Q000503:physiopathology / Q000534:rehabilitation*; D009788:Occupational Therapy / Q000379:methods*; D017063:Outcome Assessment, Health Care; D012720:Severity of Illness Index; D016037:Single-Blind Method
keywords: Multiple sclerosis; controlled clinical trials; hand function; home-based training program; manual dexterity; manual therapies; randomized