Abstract Details

Title Development of higher resolution biomechanical outcomes for upper extremity function

Topic Multiple Sclerosis

Presentation(s) MS and CNS Inflammatory Disease Posters (7:00 AM-5:00 PM)

Poster/Presentation
Number 028

Objective To determine the longitudinal evolution of novel upper extremity (UE) biomechanical outcomes and baseline predictors of longitudinal change.

Background

The 9-Hole Peg Test (9HPT) is an established neuroperformance measure of UE function in multiple sclerosis (MS). The conventional 9HPT is limited to a single dimensional outcome representing total time to complete the task. A technology-enabled iPad^® adaptation of the 9HPT (Manual Dexterity Test [MDT]) allows intra-task biomechanical outcomes to be measured.

Design/Methods An advanced mathematical model was constructed in conjunction with motion capture analysis to yield novel outcomes, leveraging intra-task sensor-grade information hypothesized to provide key insights into specific motor control mechanisms. The data for this analysis were collected from 10 collaborating MS PATHS centers between 9/2016 and 8/2019. MDT intra-task measures with the best cross-sectional correlations to Patient Determined Disease Steps (PDDS) and Neuro-Qol were investigated. Mixed effects regression models determined longitudinal change with age, disease duration, sex, education, disease course, Neuro-QoL upper extremity, and PDDS as fixed effects and a subject random effect.

Results The study population comprised 15358 patients (mean age 49.1 ± 12.5, disease duration 14.9 ± 11.2 yrs, progressive MS 23 %, baseline MDT 28.3 ± 10.6 sec, number of visits 2.9 ± 1.9). MDT total time and all novel outcomes demonstrated change over time (p<0.001) after adjustment for confounders. Movement time with peg in hand, movement time, and average velocity showed greatest sensitivity to change. Greater change over time was found in those with a progressive disease course (p<0.002 for all) and higher PDDS scores (p<0.001).

Conclusions Intra-task MDT outcomes showed greater sensitivity to change than the standard task completion time. The results support the hypothesis that multi-dimensional biomechanical measures derived from an adapted 9HPT task may enhance capacity to detect progressive UE impairment change in MS.

Authors/Disclosures
Marisa P. McGinley, DO (Cleveland Clinic) PRESENTER	Dr. McGinley has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Genentech. Dr. McGinley has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for EMD Serono. The institution of Dr. McGinley has received research support from Biogen. The institution of Dr. McGinley has received research support from Genentech. The institution of Dr. McGinley has received research support from NIH. The institution of Dr. McGinley has received research support from AHRQ. The institution of Dr. McGinley has received research support from EMD Serono.
	No disclosure on file
	No disclosure on file
David D. Schindler, BS (Motion Med LLC)	No disclosure on file
Andrija Javor	Andrija Javor has received personal compensation for serving as an employee of Biogen. Andrija Javor has received stock or an ownership interest from Biogen.
Dawei Liu	Dawei Liu has received personal compensation for serving as an employee of Biogen. Dawei Liu has received stock or an ownership interest from Biogen.
Nicholas Levitt	Nicholas Levitt has received personal compensation for serving as an employee of Biogen Inc..
Christine C. Guo, PhD	No disclosure on file
James R. Williams III, PhD	Dr. Williams has received personal compensation for serving as an employee of Biogen. Dr. Williams has received stock or an ownership interest from Biogen.
Irene Koulinska	Irene Koulinska has received personal compensation for serving as an employee of Biogen.
Shibeshih Belachew, MD	Dr. Belachew has received personal compensation for serving as an employee of Biogen Inc. Dr. Belachew has received stock or an ownership interest from Biogen Inc.
Robert A. Bermel, MD, FAAN (Cleveland Clinic)	Dr. Bermel has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Sanofi/Genzyme. Dr. Bermel has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Genentech/Roche. Dr. Bermel has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Novartis. Dr. Bermel has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for TG Therapeutics. The institution of Dr. Bermel has received research support from Biogen. The institution of Dr. Bermel has received research support from Roche. The institution of Dr. Bermel has received research support from Novartis. Dr. Bermel has received intellectual property interests from a discovery or technology relating to health care.
Jeffrey A. Cohen, MD (Cleveland Clinic)	Dr. Cohen has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Convelo. Dr. Cohen has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Astoria. Dr. Cohen has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Bristol Myers Squibb. Dr. Cohen has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Viatris. Dr. Cohen has received personal compensation in the range of $500-$4,999 for serving as a Consultant for PSI. Dr. Cohen has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Shionogi. Dr. Cohen has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Celltrion.
Daniel Ontaneda, MD, PhD, FAAN (Cleveland Clinic)	Dr. Ontaneda has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novartis. Dr. Ontaneda has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Genentech/Roche. Dr. Ontaneda has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biogen Idec. Dr. Ontaneda has received personal compensation in the range of $500-$4,999 for serving as a Consultant for BMS. Dr. Ontaneda has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Sanofi. The institution of Dr. Ontaneda has received research support from NIH. The institution of Dr. Ontaneda has received research support from PCORI. The institution of Dr. Ontaneda has received research support from NMSS. The institution of Dr. Ontaneda has received research support from Genetech.
	No disclosure on file

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