Use of a physiological profile to document upper limb motor impairment in ageing and in neurological conditions

• Published in: The Journal of physiology Vol. 601; no. 12; pp. 2251 - 2262
• Main Authors: Ingram, Lewis A., Butler, Annie A., Lord, Stephen R., Gandevia, Simon C.
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01.06.2023; John Wiley and Sons Inc
• Subjects: Adult; Aged; ageing; Aging - physiology; Coordination; Fingers; Hand Strength; Humans; Life span; Motor Disorders; Motor Skills - physiology; Movement disorders; Multiple sclerosis; Neurodegenerative diseases; Parkinson's disease; Physiology; Reaction time task; Sensation; Stroke; Tactile stimuli; Topical Review; Upper Extremity; upper limb; upper limb; ageing; movement disorders
• ISSN: 0022-3751; 1469-7793
• DOI: 10.1113/JP283703

Profiling performance in the physiological domains underpinning upper limb function (such as strength, sensation, coordination) provides insight into an individual's specific impairments. This compliments the traditional medical ‘diagnosis’ model that is currently used in contemporary medicine. From an initial battery of 13 tests in which data were collected across the adult lifespan (n = 367, 20–95 years) and in those with neurological conditions (specifically, multiple sclerosis (n = 40), Parkinson's disease (n = 34), and stroke (n = 50)), six tests were selected to comprise a core upper limb physiological profile assessment (PPA). This comprised measures of handgrip strength, simple reaction time, finger dexterity, tactile sensation, bimanual coordination, and a functional task. Individual performance in each of these tests can be compared to a reference population score (devised from our database of healthy individuals aged under 60 years), informing the researcher or clinician how to best direct an intervention or treatment for the individual based on their specific impairment(s). Lastly, a composite score calculated from the average performance across the six tests provides a broad overview of an individual's overall upper limb function. Collectively, the upper limb PPA highlights specific impairments that are prevalent within distinct pathologies and reveals the magnitude of upper limb motor impairment specific to each condition. figure legend The upper limb physiological profile assessment (PPA) was designed to quantify sensory and motor impairments that may compromise independence with daily activities involving the upper limbs. A battery of six tests enables the researcher or clinician to identify specific strengths and limitations for each individual, which may be used to direct treatment and management strategies. We report normative data collected across the adult lifespan for each test, which we then used as a reference to compare performance to people with multiple sclerosis, Parkinson's disease and stroke. From this, we provide a general physiological profile for each of these distinct pathologies.