Manual dexterity and related functional limitations in HMSN/CMT

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Disabil Rehabil. 2007 Jun 13;:1-5

Manual dexterity and related functional limitations in Hereditary

Motor and Sensory Neuropathy. An explorative study.

Videler AJ, Beelen A, Nollet F.

Department of Rehabilitation, Academic Medical Center, University of

Amsterdam, The Netherlands.

Purpose. To explore impairments in manual dexterity and perceived

limitations in upper extremity-related activities in subjects with

Hereditary Motor and Sensory Neuropathy (HMSN).

Method. Cross-sectional study of 20 HMSN subjects. Manual dexterity

was assessed using the Jebsen test of hand function. Perceived

limitations were assessed using the Rehabilitation Activities

Profile (RAP) and the Disabilities of Arm, Shoulder and Hand

questionnaire (DASH).

Results. Impaired manual dexterity was found in four out of seven

Jebsen sub-tests. Turning over cards, lifting large light and large

heavy objects were most impaired, as reflected by median z scores of

5.7, 12.0 and 16.9, respectively. Perceived limitations, as

reflected by median and percentile (P25; P75) sum-scores, were 7.5

(3; 11.7) for the RAP domains of personal care (scale 0 - 69) and

6.0 (1.25; 15.5) for the domains of occupation (scale 0 - 42). The

median (P25; P75) DASH score (scale 0 - 100) was 13.3 (2.7; 48.1).

Jebsen test scores were significantly associated with RAP and DASH

scores.

Conclusions. Manual dexterity of HMSN subjects, especially requiring

the manipulation of flat and of large objects, was impaired and

associated with the amount of perceived limitations in upper

extremity function. Major limitations were perceived in activities

related to upper extremity function by 25% of HMSN subjects.

Measurement of manual dexterity and perceived limitations should be

incorporated into the evaluation and treatment of HMSN subjects.