The minnesota manual dexterity test as a bimanual performance measure in people with multiple sclerosis.

BACKGROUND: Increasing knowledge about unilateral or bilateral upper limb (UL) involvement in multiple sclerosis (MS) has revealed the need for an objective assessment tool. OBJECTIVE: The aims of our study were to evaluate manual dexterity using Minnesota Manual Dexterity Test (MMDT) in people with MS (pwMS), to investigate the validity and feasibility of MMDT, and to examine its relationship with other variables. METHODS: Eighty pwMS and forty healthy controls were enrolled. Demographic and clinical characteristics of pwMS were recorded, and manual dexterity, activity performance of the UL, hand grip and pinch strength, and fatigue levels were evaluated. Validity was performed using the Nine Hole Peg Test (NHPT). Feasibility was evaluated with questions directed to pwMS. The relationship between MMDT and strength, ABILHAND, fatigue, Expanded Disability Status Scale (EDSS) and disease duration was examined and multiple regression analysis was established. RESULTS: For the MMDT of pwMS were mean placing-dominant 82.73 s, mean placing-nondominant 88.6 s, and mean two-hand turning and placing 61.75 s. All results were statistically significantly different compared to healthy controls. There was moderate to high correlation between the subtests of the MMDT and the NHPT. 85-90% positive feedback was received for the feasibility of MMDT. A significant interaction was found between all subtests of MMDT and EDSS, ABILHAND and disease duration in predicting manual dexterity scores. CONCLUSIONS: MMDT is a valid and feasible tool for assessing manual dexterity and it can be used as an appropriate outcome measure in researches aiming to evaluate bilateral UL function in pwMS.

Effectiveness of home-based telerehabilitation in mild to moderate Alzheimer's disease: A randomised controlled study.

BACKGROUND: The COVID-19 pandemic has made it necessity that rehabilitation services are provided remotely to patients. These process required a transformation in healthcare. The aim of this study was investigate the effectiveness of the home-based online supervised exercise program in Alzheimer's disease (AD). To our knowledge, this is the first study to report the results of real-time supervised physical exercise telerehabilitation program in AD. METHOD: Eighteen subjects with early-middle stage of AD were randomised into 2 group as telerehabilitation group (TG; mean age: 77.7 ± 5.29 years; 7 Female, 3 Male) and control group (CG; mean age: 78.5 ± 7.07 years; 5 Female, 3 Male). Our primary outcome was Mini-Mental State Examination (MMSE), seconder outcomes were Timed Up&Go (TUG), One-leg Balance Test (OLBT), Functional Independence Measure (FIM), Geriatric Depression Scale-Short Form (GDS). The 6-week motor-cognitive dual-task exercise training was performed online and under the supervision of physiotherapist through videoconference. No physical or cognitive intervention was applied to the control group for 6 weeks. Subjects were assessed before and after the treatment. In statistical analysis, the change in the outcome scores was calculated (∆ = last measurement-first measurement), the difference between the groups was performed with the Mann Whitney-U Test in SPSS 22.0. Trial's protocol is registered with Clinicaltrials.gov under number NCT04606251. RESULT: There was a significant difference between TG and CG in favor of TG in MMSE, TUG, FIM and GDS (p<0,05); There was no significant difference between groups in OLBT (p>0,05). Statistical results have been showed in Table 1. No safety problem was observed during the treatment. All subjects were completed the study, there was a high adherence to treatment. CONCLUSION: Physical exercise treatment with telerehabilitation was feasible, safe and well-accepted by people with early-middle stage of AD. Online-supervised exercise program can improve cognitive function, functional mobility, independence and reduce depressive symptoms.