The Nine-Hole Peg Test as a manual dexterity performance measure for multiple sclerosis.
The Nine-Hole Peg Test as a manual dexterity performance measure for multiple sclerosis.
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DOI：
10.1177/1352458517690824
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发表时间：
2017-04
期刊：
影响因子：
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通讯作者：
Multiple Sclerosis Outcome Assessments Consortium
中科院分区：
文献类型：
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作者：
Feys P;Lamers I;Francis G;Benedict R;Phillips G;LaRocca N;Hudson LD;Rudick R;Multiple Sclerosis Outcome Assessments Consortium
手灵巧度受损是多发性硬化症 (MS) 患者常见的一种残疾，并且随着疾病的恶化而变得越来越普遍。虽然有各种测试和患者报告的结果测量可供使用，但九孔钉测试 (NHPT) 被认为是测量手动灵活性的黄金标准，最常用于多发性硬化症研究和临床实践。多发性硬化症结果评估联盟 (MSOAC) 包括来自倡导组织、美国食品药品监督管理局 (FDA)、欧洲药品管理局 (EMA)、国家神经疾病和中风研究所 (NINDS)、学术机构、行业合作伙伴以及多发性硬化症患者的代表。 MSOAC 的目标之一是监管机构对高度可靠、有效、实用、具有成本效益且对多发性硬化症患者有意义的绩效结果进行认可和鉴定。这些神经性能指标的关键一步是阐明临床相关基准、明确定义的残疾程度以及被认为具有临床意义的变化梯度。本文讨论了 NHPT，即拟议的上肢功能 MSOAC 测量方法。我们发现 NHPT 在测试期间和测试期间都是可靠的，能够区分健康受试者和具有不同程度上肢损伤的 MS 患者，并且与其他手动灵活性以及更全面的上肢测量显示出较高的收敛效度。生态有效性是通过其与日常生活中感知的上肢使用和进行日常生活活动的感知困难的关系来建立的。 NHPT 对纵向研究中的恶化做出反应，研究表明，测试分数的 20% 变化通常用于定义有临床意义的恶化，这一定义需要在疾病的所有阶段进一步验证。
Impaired manual dexterity is a frequently reported disability in people with multiple sclerosis (MS) and is increasingly prevalent with worsening disease. While various tests and patient-reported outcome measures are available, the Nine-Hole Peg Test (NHPT) is considered as a gold standard measure of manual dexterity and most frequently used in MS research and clinical practice. The MS Outcome Assessments Consortium (MSOAC) includes representatives from advocacy organizations, Food and Drug Administration (FDA), European Medicines Agency (EMA), National Institute of Neurological Disorders and Stroke (NINDS), academic institutions, and industry partners along with persons living with MS. Among the MSOAC goals are acceptance and qualification by regulators of performance outcomes that are highly reliable and valid, practical, cost-effective, and meaningful to persons with MS. A critical step for these neuroperformance metrics is elucidation of clinically relevant benchmarks, well-defined degrees of disability, and gradients of change that are deemed clinically meaningful. This article addresses the NHPT, the proposed MSOAC measure for upper extremity function. We find that the NHPT is reliable within and between test sessions, discriminates between healthy subjects and MS patients with different levels of upper limb impairment, and shows high convergent validity with other manual dexterity as well as more comprehensive upper limb measures. Ecological validity is established by its relation to perceived upper limb use in daily life and perceived difficulty in performing activities of daily living. The NHPT is responsive to deterioration in longitudinal studies, and research suggests that a 20% change in test score is commonly used to define clinically meaningful worsening, a definition that needs further validation in all stages of the disease.