Manual dexterity in HMSN (CMT) 1A: Severity of limitations and feasibility and

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J Rehabil Med. 2008 Feb;40(2):132-136.

Manual dexterity in hereditary motor and sensory neuropathy type 1a:

Severity of limitations and feasibility and reliability of 2

assessment instruments.

Videler AJ, Beelen A, van Schaik IN, de Visser M, Nollet F.

Department of Rehabilitation, A01, Academic Medical Center,

University of Amsterdam, PO Box 22660.

OBJECTIVE: To assess the prevalence and significance of impaired

manual dexterity in hereditary motor and sensory neuropathy type 1a

(HMSN 1a), with the Sollerman hand function and the Functional

Dexterity test, and compare the reliability and agreement of the

tests. DESIGN: Descriptive cross-sectional study.

SUBJECTS: Forty-nine subjects with HMSN 1a.

RESULTS: Forty-six (94%) subjects had an abnormal Sollerman sum score

(< 80) for the dominant hand. The most difficult subtests required

finger grips such as pulp, tripod and lateral pinches. Dexterity

scores of both hands were categorized as " moderately functional " .

Test-retest reliability was excellent for the Sollerman test, with

intraclass correlation coefficients between 0.98 and 0.99 (95%

confidence interval (CI) 0.97-0.99), and good for Functional

Dexterity test scores with correlation coefficients between 0.83 and

0.95 (95% CI. 71-0.97). The 95% limits of agreement between Sollerman

tests showed that differences greater than 3 points can be

interpreted as a change in dexterity. The Functional Dexterity test

limits were wide.

CONCLUSION: Impaired manual dexterity is common among subjects with

HMSN 1a, stressing that the evaluation of dexterity is an essential

element of the functional assessment. Both tests are able to detect

impaired manual performance in HMSN 1a. For monitoring of disease

progression and the effects of treatment programmes the Sollerman

test is most suitable.