Manual dexterity & related functional limitations in HMSN(CMT)

[Guest guest]

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.

[Guest guest]

These are the Doctors I worked with at the University of Amsterdam's

Academic Medical Center.

Dr. Videler is a magnificently beautiful woman, with whom I fell

immediately in love (although she unfortunately married), and she and

a technician built the hand brace I spoke of. She had some pictures

made of my hands working with and without the brace. She uses these

pictures in lectures she gives.

Dr,. Nollet is the man who said to me when he first saw me, " I know I

can help you to walk better with a special pair of shoes. "

And he did. The shoes are the best thing to happen since my tendon

transfer operations 25 years ago.

Interesting that their names should show up here!

P.S. I was given the manual dexterity test they speak of here.

[Guest guest]

These are the Doctors I worked with at the University of Amsterdam's

Academic Medical Center.

Dr. Videler is a magnificently beautiful woman, with whom I fell

immediately in love (although she was unfortunately married), and she

and a technician built the hand brace I spoke of. She had some

pictures made of my hands working with and without the brace. She uses

these pictures in lectures she gives.

Dr,. Nollet is the man who said to me when he first saw me, " I know I

can help you to walk better with a special pair of shoes. "

And he did. The shoes are the best thing to happen since my tendon

transfer operations 25 years ago.