Aim:

To adopt a computer-based protocol to assess grip fatigability in patients with pediatric-onset multiple sclerosis to provide detection of subtle motor involvement identifying those patients most at risk for future decline.

Method:

Pediatric-onset multiple sclerosis patients were recruited during routine outpatient visits to complete a grip assessment and compared to a group of healthy age- and sex-matched controls. All participants completed a computer-based measurement of standard maximal grip strength and repetitive and sustained grip performance measured by dynamic and static fatigue indices.

Results:

A total of 38 patients with pediatric-onset multiple sclerosis and 24 healthy controls completed the grip protocol (right-hand dominant). There were no significant group differences in maximal grip strength bilaterally (right: 21.8 vs 19.9 kg, P = .25; left: 20.4 vs 18.7 kg, P = .33), although males with pediatric-onset multiple sclerosis were significantly less strong than healthy controls (right: 26.53 vs 21.23 kg, P = .009; left; 25.13 vs 19.63 kg, P = .003). Both dynamic and static fatigue indices were significantly higher bilaterally in pediatric-onset multiple sclerosis compared with healthy control participants (left-hand dynamic fatigue index: 18.6% vs 26.7%, P = .003; right-hand static fatigue index: 28.3% vs 41.3%, P < .001; left-hand static fatigue index: 31.9% vs 42.6%, P < .001).

Conclusion:

Brief repeatable grip assessment including measures of dynamic and sustained static output can be a sensitive indicator of upper extremity motor involvement in pediatric-onset multiple sclerosis, potentially identifying those in need of intervention to prevent future disability.

中文翻译：

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上肢运动疲劳作为小儿多发性硬化症的早期指标

目的：

采用基于计算机的协议来评估小儿多发性硬化症患者的握把疲劳性，以检测细微运动受累，从而识别那些最有可能在未来衰退的患者。

方法：

在常规门诊就诊期间招募小儿多发性硬化症患者以完成握力评估，并与一组健康的年龄和性别匹配的对照组进行比较。所有参与者都完成了基于计算机的标准最大握力以及通过动态和静态疲劳指数测量的重复和持续握力性能的测量。

结果：

共有 38 名小儿多发性硬化症患者和 24 名健康对照者完成了握持方案（右手主导）。双侧最大握力没有显着的组间差异（右：21.8 vs 19.9 kg，P = .25；左：20.4 vs 18.7 kg，P = .33），尽管患有儿童多发性硬化症的男性明显不如健康对照组（右：26.53 vs 21.23 kg，P = .009；左；25.13 vs 19.63 kg，P = .003）。与健康对照组相比，儿童多发性硬化症患者的双侧动态和静态疲劳指数均显着高于健康对照组（左侧动态疲劳指数：18.6% vs 26.7%，P= .003; 右手静态疲劳指数：28.3% vs 41.3%，P < .001；左手静态疲劳指数：31.9% vs 42.6%，P < .001）。

结论：

包括动态和持续静态输出测量在内的简短可重复握力评估可能是小儿多发性硬化症中上肢运动受累的敏感指标，可能识别那些需要干预以防止未来残疾的人。