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Background: In multiple sclerosis (MS) upper limb neurological impairments, are an important driver of disability and handicap. The gold standard for assessing upper limb function is the 9-hole peg test (9HPT). One disadvantage of the current plastic version is its price, which prevents its widespread use as a self-monitoring tool by the MS community.
Objective: To develop and validate an affordable cardboard version of 9HPT for patients to self-monitor upper limb function at home. The aim is not to replace the plastic version, which would stay the gold standard in MS centers.
Methods: We enrolled 177 volunteers, 68 healthy controls and 109 people with MS (pwMS) at varying stages of their disease. Volunteers performed two trials of the 9HPT with their dominant hand and two with their non-dominant hand using both plastic 9HPT and cardboard 9HPT. The primary comparison parameter was the time needed to perform the task.
Results: The mean score for the cardboard 9HPT was 24.58 (SEM 1.54s) seconds compared to 26.03 (SEM 1.44s) seconds for the plastic 9HPT (p = 0.007). However, the two versions of the tests correlated very strongly, r = 0.96 (p < 0.001). The coefficient of variation, repeat-repeat testing, showed less variability with the cardboard version than in the plastic one with 10% and 14%, respectively. Two-thirds of pwMS preferred using the cardboard version.
Conclusion: This study demonstrates that the cardboard version is at least equivalent to the plastic version of the test with arguably better design attributes making it the preferred option for self-monitoring.
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http://dx.doi.org/10.1016/j.msard.2017.08.002 | DOI Listing |
CNS Neurosci Ther
September 2025
School of Information and Communication Engineering, North University of China, Taiyuan, China.
Aims: Decoding the motor intention by electroencephalography to control external devices is an effective method of helping spinal cord injury (SCI) patients to regain motor function. Still, SCI patients have much lower accuracy in the decoding of motor intentions compared to healthy individuals, which severely hampers the clinical application. However, the underlying neural mechanisms are still unknown.
View Article and Find Full Text PDFInd Health
September 2025
Dokuz Eylul University, Faculty of Medicine, Department of Occupational Medicine, Turkey.
Jockeys endure considerable physical and psychological demands, rendering them vulnerable to occupational injuries such as fractures, concussions, and soft tissue damage. This descriptive case series presents the medical and occupational histories of three professional jockeys with long-term disabilities following work-related accidents. Each individual commenced their jockey career in early adolescence.
View Article and Find Full Text PDFWorld Neurosurg
September 2025
Swedish Neuroscience Institute, Seattle, WA; Seattle Science Foundation, Seattle, WA.
Introduction: Lateral Lumbar Interbody Fusion (LLIF) is based on a less-invasive access corridor through the retroperitoneum and psoas muscle, though concerns persist over postoperative weakness and neuropathy on the surgical side. This study investigates if the trans-psoas LLIF approach is associated with long-term changes in psoas morphology, hip flexor (HF) weakness, and lower extremity dysesthesia.
Methods: The authors retrospectively reviewed all LLIF cases at a single institution from January 2016 to June 2024.
Rev Esp Anestesiol Reanim (Engl Ed)
September 2025
Instituto Nacional de Rehabilitación, Ciudad de México, Mexico.
Brachial plexus block at the interscalene level is a regional anesthetic technique widely used to provide analgesia in shoulder and upper extremity surgery; However, it is associated with a high incidence of phrenic nerve block with diaphragmatic paralysis which has clinical implications in patients with underlying respiratory disease, showing respiratory difficulty symptoms. As consequence, it has been contraindicated in certain population groups. Once diaphragmatic paralysis and respiratory symptoms are established, management is supportive and expectant.
View Article and Find Full Text PDFJ Hand Surg Am
September 2025
Department of Orthopaedic Surgery, SUNY Downstate Health Sciences University, Brooklyn, NY.
Purpose: This study aimed to evaluate how major US health care policy changes have influenced long-term Medicare reimbursement trends for upper-extremity flap and microvascular procedures from 2002 to 2023.
Methods: Reimbursement data for 28 common flap and microvascular procedures were extracted from the Medicare Physician Fee Schedule database using Current Procedural Terminology codes. Adjustments for inflation were made using the Consumer Price Index.