Upper Limb Function Assessment in Multiple Sclerosis

Upper limb dysfunction is a hallmark feature of multiple sclerosis, affecting fine motor control, strength and coordination, and significantly impairing activities of daily living. Clinical evaluation traditionally relies on neurological scales such as the Expanded Disability Status Scale to grade impairment, alongside performance tests that include the 9-Hole Peg Test for manual dexterity and the Action Research Arm Test for functional capacity. Complementary patient-reported questionnaires capture perceived limitations in arm and hand use, while instrumented methods—such as surface electromyography and motion analysis—provide objective metrics of muscle activation and kinematic profiles. Recent advances have embraced digital health technologies, employing wearable sensors and smartphone-based tasks to monitor upper limb performance remotely and continuously. These approaches seek to detect subtle changes over time, inform personalised rehabilitation strategies and evaluate the efficacy of interventions ranging from robotic assistance to game-based training. An integrated assessment framework that combines clinical scales, patient perspectives and digital markers is now emerging as the standard for comprehensive evaluation of upper limb function in people with multiple sclerosis.

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Upper Limb Function Assessment in Multiple Sclerosis publication trend

The graph below shows the total number of articles in upper limb function assessment in multiple sclerosis across all publications each year (not limited to Nature Index journals).

Technical terms

9-Hole Peg Test (9HPT): A timed measure of manual dexterity in which a participant places and removes pegs from holes as quickly as possible.

Expanded Disability Status Scale (EDSS): A clinician-rated scale ranging from 0 (normal) to 10 (death due to MS), assessing neurological impairment and ambulation.

Patient-Reported Outcome Measure (PROM): A self-administered questionnaire capturing a patient’s perception of their functional ability or quality of life.

Surface Electromyography (sEMG): A non-invasive technique for recording electrical activity of muscles through electrodes placed on the skin.

Sensor-based assessment: The use of wearable or mobile sensors to quantify movement kinematics and kinetics outside traditional laboratory settings.

References

1. Personalized Longitudinal Assessment of Multiple Sclerosis Using Smartphones. IEEE Journal of Biomedical and Health Informatics (2023).
2. sEMG-controlled forearm bracelet and serious game-based rehabilitation for training manual dexterity in people with multiple sclerosis: a randomised controlled trial. Journal of NeuroEngineering and Rehabilitation (2023).
3. The correlation between 9-HPT and patient-reported measures of upper limb function in multiple sclerosis: a systematic review and meta-analysis. Journal of Neurology (2023).