Turkiye Klinikleri Journal of Medical Sciences

.: ORIGINAL RESEARCH
Comparison of Upper and Lower Extremity Functions in Primary and Secondary Progressive Multiple Sclerosis Patients
Primer ve Sekonder Progresif Multipl Skleroz Hastalarında Üst ve Alt Ekstremite Fonksiyonlarının Karşılaştırılması
Nuray ATİLLAa, Vedat ÇİLİNGİRa, Aysel MİLANLIOĞLUa, Abdullah YILGÖRa
aDepartment of Neurology, Van Yüzüncü Yıl University Faculty of Medicine, Van, TURKEY
Turkiye Klinikleri J Med Sci. 2019;39(4):389-94
doi: 10.5336/medsci.2019-65439
Article Language: EN
Full Text
ABSTRACT
 Objective: The aim of this study was to find out whether upper extremity is relatively preserved and to what extent it is affected by Primary Progressive Multiple Sclerosis (PPMS) through the evaluation and comparison of upper extremity fine motor skills and walking ability in PPMS and Secodary Progressive Multiple Sclerosis (SPMS) patients with Expanded Disability Status Scale (EDSS) score of 4 and above. Material and Methods: A total of 65 progressive Multiple Sclerosis (MS) patients admitted to the Neurology Outpatient Clinic of Yüzüncü Yıl University Faculty of Medicine between January and December 2017 with EDSS scores ranging from 4.0 to 8.5 were included in our study. Expanded Disability Status Scale (EDSS), 9-Hole Peg Test (9-HPT) and Timed 25-Foot Walk (T25FW) Test were applied to the patients. Results: 9-Hole Peg Test right hand score of PPMS patients with EDSS score between 5.1 and 6.0 was 32.89±7.42 sec, whereas in SPMS patients within the same score range, it was 56.15±54.57 sec (p>0.05). 9- Hole Peg Test left hand score was found as 39.64±16.71 sec in PPMS patients and 47.51±27.32 sec (p>0.05) in SPMS patients. 9-Hole Peg Test mean score was 36.25±11.83 sec in PPMS patients and 51.83±38.18 sec in SPMS patients (p>0.05). The T25FW test was calculated only for 39 patients who were able to perform all tests. In 14 patients with PPMS, the first-stage T25FW test score was 35.62±22.2 sec, the second-stage score was 36.21±24.73 sec, and the mean T25FW test score was 35.92±22.81 sec. In 25 of SPMS patients, the first-stage T25FW test result was 36,12±32,84 sec, the second-stage T25FW test result was 32,77±26,11 sec, and the mean T25FW test result was 34,4±28,75 sec. Conclusion: In PPMS and SPMS patients with EDSS score of 5.1-6.0, the mean EDSS scores were observed to be closer to each other, and in PPMS patients in this group, the upper extremity function was relatively better, although not statistically significant. No significant difference was found between the groups in terms of lower extremity function.

Keywords: Upper and lower extremity function in patients with progressive MS; 9-Hole Peg test (9-HPT) and Timed 25-Foot Walk (T25FW)
ÖZET
 Amaç: Çalışmamızın amacı Primer Progresif Multipl Skleroz (PPMS) ve Sekonder Progresif Multipl Skleroz (SPMS) hastalarında Genişletilmiş Özürlülük Durum Ölçeği (EDSS) puanı 4 ve üzerinde olan hasta grubunda üst ekstremite ince motor becerisini ve yürüme becerisini değerlendirip birbiri ile kıyaslayarak, PPMS'de üst ekstremitenin göreceli olarak korunup korunmadığını ve ne derecede etkilendiğini göstermektir. Gereç ve Yöntemler: Çalışmamıza 2017 yılı Ocak-Aralık ayları arasında Yüzüncü Yıl Üniversitesi Tıp Fakültesi Nöroloji polikliniğine başvuran EDSS 4,0-8,5 arasında olan toplam 65 progresif Multipl Skleroz (MS) hastası dahil edilmiştir. Hastalara Expanded Disability Status Scala(EDSS, Genişletilmiş Özürlülük Durum Ölçeği), 9-Hole PEG testi (9-HPT, Dokuz delikli çubuk testi) ve Timed 25 Food Walk (25 Adımlı Yürüme Testi,T25FW) testleri uygulandı. Bulgular: Genişletilmiş Özürlülük Durum Ölçeği 5.1-6.0 arasındaki hastalarda sağ el testi PPMS hastalarında 32,89±7,42 sn, SPMS hastalarında 56,15±54,57 (p>0.05) sn bulunmuştur. Sol el testi PPMS hastalarında 39,64±16,71 sn, SPMS hastalarında 47,51±27,32 sn (p>0,05) bulunmuştur. Ortalama el testi PPMS hastalarında 36,25±11,83 sn, SPMS hastalarında 51,83±38,18 sn (p>0,05) bulunmuştur. Yürüme testi sadece tüm testleri yapabilen 39 hastada hesaplanmıştır. On dört PPMS hastasında birinci tur yürüme testi 35,62±22,2 sn, ikinci tur yürüme testi 36,21±24,73 sn, ortalama yürüme testi 35,92±22,81 sn bulunmuştur. Yirmi beş SPMS hastasında ise birinci tur yürüme testi 36,12±32,84 sn, ikinci tur yürüme testi 32,77±26,11 sn, ortalama yürüme testi 34,4±28,75 sn bulunmuştur (p>0.05). Sonuç: Genişletilmiş Özürlülük Durum Ölçeği skoru 5,1-6,0 arasındaki PPMS ve SPMS hastalarında EDSS ortalaması birbirine daha yakın olduğu ve bu gruptaki PPMS hastalarında üst ekstremite fonksiyonunu istatistiksel olarak anlamlı olmasa da göreceli olarak daha iyi olduğu görülmüştür. Alt ekstremite fonksiyonu açısından her iki grup arasında anlamlı fark bulunmamıştır.

Anahtar Kelimeler: Progresif MS hastalarında üst ve alt extremite fonksiyonu, 9-Hole PEG testi (9-HPT, Dokuz delikli çubuk testi) ve timed 25 Food Walk (25 adımlı yürüme testi,T25FW)
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