Multipl Sklerozlu ve Radyolojik İzole Sendroma Sahip Bireylerde Kognitif ve Motor İkili Görevin Üst Ekstremite Fonksiyonları Üzerine Etkisinin Araştırılması

Abstract

This study was designed to investigate the effect of cognitive and motor dual task on upper extremity function in individuals with multiple sclerosis (MS) and radiologically isolated syndrome (RIS). The study included 26 individuals with MS (Expanded Disability Status Scale≤3.5), 12 individuals with RIS and 26 healthy individuals aged 18-65 years. Grip strength with a dynamometer, pinch strength with a pinchmeter, fine dexterity with the Purdue Pegboard Test (PPBT) and gross dexterity with the Box-Block Test (BBT) were assessed first as a single task and then as dual tasks with a cognitive additional task and a motor additional task. Dual task cost were calculated separately for the cognitive and motor additional tasks. When the cognitive dual task cost (CDTC)) and motor dual task cost (MDTC) were analyzed within groups, the CDTC in the MS group was higher than the MDTC in terms of grip strength for the right hand (p=0.008) and BBT performance (psağ=0.014 and psol=0.002). In the RIS group, the CDTC was higher than the MDTC for the left hand only in grip strength (p=0.011). In the healthy group, the CDTC was higher than the MDTC only for the right hand in PPBT (p=0.048) and in BBT (psağ=0.001 and psol=0.001). When the three groups were compared in terms of CDTC, a difference was found between the groups only in the right hand performance of BBT (p=0.020). When the group from which the difference originated was analyzed, a significant difference was found between the RIS group and the healthy group (p=0.006). When the three groups were compared in terms of MDTC, no difference was found in any parameter (p>0.05). As a result of the study, gross motor skill and grip strength were more affected by the cognitive task than the motor task in the MS and RIS group, whereas both fine and gross motor skill were more affected by the cognitive task, although there was no difference in terms of grip strength in healthy subjects. This shows that fine manual dexterity has a similar effect in the patient groups regardless of motor and cognitive additional task. This result suggests that the motor dual task is less challenging than the cognitive task in healthy subjects, whereas it may be as challenging as the cognitive task in patient groups due to pyramidal, cerebellar and/or sensory problems that may affect manual dexterity. Motor dual tasks should be added to treatment programs by combining them with fine skills instead of gross skills.