Participation Restriction in People With Multiple Sclerosis: Prevalence and Correlations With Cognitive, Walking, Balance, and Upper Limb Impairments.
To calculate the percentage of participation restrictions according to disability level in multiple sclerosis (MS), and to assess the relationship between participation restrictions and cognitive, gait, balance, and upper limb deficits.



Cross-sectional study.



Rehabilitation unit.



Participants (N=125) consisted of people with MS (n=105) and healthy subjects (HS; n=20).



Not applicable.



The Community integration Questionnaire was used to assess participation in home, social, and productive activities. Percentages of people with MS having Community Integration Questionnaire scores lower than the 10th percentile of those of HS were calculated for each subscale to categorize the persons with participation restrictions. Cognitive deficits (Symbol Digit Modalities Test), walking disability (25-ft walking test/Expanded Disability Status Scale [EDSS]), balance disorders (Bohannon Standing Balance Test), and manual dexterity (Nine Hole Peg Test) were recorded.



Seventy-seven percent of participants showed participation restrictions, which increased with higher EDSS scores from 40% (EDSS<4) to 82% (EDSS>5.5). Social participation was more restricted than home integration, with <20% of participants shopping for groceries alone. Cognitive deficits were more highly associated (r=.60) with participation restrictions than balance (r=.47), gait (r=-.45), and hand dexterity (r=.45) limitations.



Participation restrictions are present in MS and increase with disability level. However, the results also show that MS does not restrict participation in all domains. Participation restrictions at home are less restricted compared with social participation. Cognitive disorders are more associated with participation restrictions than physical limitations.
LaRiCE Lab: Gait and Balance Disorders Laboratory; Don Gnocchi Foundation IRCCS, Rome, Italy. Electronic address: dcattaneo@dongnocchi.it.
Davide
D
Cattaneo
REVAL-Rehabilitation Research Institute, BIOMED-Biomedical Research Institute, Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium.
Ilse
I
Lamers
LaRiCE Lab: Gait and Balance Disorders Laboratory; Don Gnocchi Foundation IRCCS, Rome, Italy.
Rita
R
Bertoni
REVAL-Rehabilitation Research Institute, BIOMED-Biomedical Research Institute, Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium.
Peter
P
Feys
LaRiCE Lab: Gait and Balance Disorders Laboratory; Don Gnocchi Foundation IRCCS, Rome, Italy.
Johanna
J
Jonsdottir
D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003072:Cognition Disorders / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D006233:Persons with Disabilities; D005260:Female; D020233:Gait Disorders, Neurologic / Q000453:epidemiology*; D006801:Humans; D007899:Leisure Activities; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000453:epidemiology*; D004856:Postural Balance; D015995:Prevalence; D012047:Rehabilitation Centers; D012720:Severity of Illness Index; D058992:Social Participation; D016138:Walking
Cognition; Community participation; Gait; Posture; Rehabilitation; Upper extremity