Abstract Details

Title Novel Biomechanical Outcomes for Upper Extremity Function

Topic Multiple Sclerosis

Presentation(s) S10 - Multiple Sclerosis: Biomarkers and Outcome Measures (3:54 PM-4:06 PM)

Poster/Presentation
Number 003

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

Background The 9-Hole Peg Test (9HPT) is an established neuroperformance measure of upper extremity function in multiple sclerosis (MS). The conventional test is limited to a single outcome (total time to complete the task). A technology-enabled iPad^® adaptation of the 9HPT (Manual Dexterity Test [MDT]) was developed, allowing novel biomechanical outcomes to be measured.

Design/Methods An advanced mathematical model, using data from 6557 MDT administrations was constructed from motion caption analysis to yield novel outcomes hypothesized to provide key insights into specific motor control mechanisms. The data for this analysis was collected from 10 collaborating MS PATHS sites between 9/2016 and 8/2019. MDT measures with the best cross-sectional correlations to 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 Patient Determined Disease Steps (PDDS) as fixed effects and a subject random effect. Statistical significance was set at p < 0.05.

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 Novel MDT outcomes showed greater sensitivity to change than the standard outcome. Novel outcomes show worsening in those with greater disability and progressive disease course. The results support the use of novel outcomes to better measure upper extremity function in MS.

Authors/Disclosures
Marisa P. McGinley, DO (Cleveland Clinic) PRESENTER	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 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.
Jingan Qu	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
Robert A. Bermel, MD, FAAN (Cleveland Clinic)	Dr. Bermel has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biogen. 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 $500-$4,999 for serving as a Consultant for Viela Bio. Dr. Bermel has received personal compensation in the range of $5,000-$9,999 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 Merck Serono. Dr. Bermel has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Astra Zeneca. Dr. Bermel has received personal compensation in the range of $500-$4,999 for serving as a Consultant for LabCorp. 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 $500-$4,999 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 Atara. Dr. Cohen has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biogen. 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 on a Scientific Advisory or Data Safety Monitoring board for Celltrion. Dr. Cohen has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Sage.
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. 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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