Impairment of fine motor dexterity in mild cognitive impairment and alzheimer's disease dementia: association with activities of daily living

Objective: Cognitive impairment is a hallmark of mild cognitive impairment (MCI) and Alzheimer’s disease dementia (AD). Although the cognitive profile of these patients and its association with activities of daily living (ADLs) is well documented, few studies have assessed deficits in fine motor dexterity and their association with ADL performance. The objective of this research paper is to evaluate fine motor dexterity performance among MCI and AD patients and to investigate its association with different aspects of ADLs. Methods: We assessed normal aging controls, patients with multiple- and single-domain amnestic MCI (aMCI), and patients with mild AD. Fine motor dexterity was measured with the Nine-Hole Peg Test and cognitive functioning by the Mattis Dementia Rating Scale. We analyzed the data using general linear models. Results: Patients with AD or multiple-domain aMCI had slower motor responses when compared to controls. AD patients were slower than those with single-domain aMCI. We found associations between cognition and instrumental ADLs, and between fine motor dexterity and self-care ADLs. Conclusion: We observed progressive slowing of fine motor dexterity along the normal aging-MCI-AD spectrum, which was associated with autonomy in self-care ADLs.

The reliability of four motor function tests for assessing upper extremity motor function in stroke patients / 中华物理医学与康复杂志

Objective To investigate the test-retest reliability and inter-rater reliability of the Fugl-Meyer assessment (FMA),Wolf's motor function test (WMFT),the box-block test (BBT) and the nine-hole peg test (NHPT) in assessing the upper limb motor function of stroke patients.Methods Eighteen stroke patients participated in the study.Each patient was assessed twice within 2 hours with the U-FMA,WMFT,the BBT and the NHPT.Two raters recorded each session separately.Test-retest reliability was investigated by comparing the assessment results of different sessions; interrater reliability was identified by analyzing the assessment results of different raters.Results The intraclass correlation coefficients (ICC) for the U-FMA were 0.988 on test-retest reliability and 0.959 on inter-rater reliability.The ICC of WMFT by mean and median time were respectively 0.996 and 0.393 on test-retest reliability and both 1.000 on inter-rater reliability.The ICC of WMFT by score mean was O.989 for test-retest reliability and 0.977 for inter-rater reliability.The ICC for test-retest reliability of the BBT using affected hand counts and the difference in counts between the affected and un-affected hand were respectively 0.975 and 0.982.The ICC of the NHPT using affected hand times and the difference between the affected hand and unaffected hand times were respectively 0.937 and 0.936 for test-retest reliability,and both 1.000 for inter-rater reliability.Conclusion The U-FMA,WMFT,the BBT and the NHPT are all measurements with good test-retest reliability and inter-rater reliability.They are reliable for assessing the upper extremity motor function of stroke patients.

Effectiveness of play therapy over conventional physiotherapy in spastic diplegic cerebral palsy children.

Background: Play therapy has become an important part of physiotherapy treatment program to improve functional outcome in children with cerebral palsy. This study is to examine the effectiveness of play therapy together with conventional therapy to improve the hand function ability in children with spastic diplegic cerebral palsy. Methods: 30 spastic diplegic cerebral palsy children were divided into two groups, Group-I received conventional physiotherapy alone where as Group-II received play therapy and conventional therapy (n=15) both. The treatment was given 3 days a week for 6 weeks continuously for both the groups. Results: After the treatment period Group II who received play therapy in addition to conventional therapy scored significantly higher on the Box and block test and Nine hole peg test for grasp and release showing p<0.05. Conclusion: Play therapy along with conventional physiotherapy was found to be much effective in improving the hand function in children with spastic diplegic cerebral palsy. This study may help the physiotherapist to utilize and evaluate the functional outcomes using play therapy in cerebral palsy children.