Evidence mapPaperPMID 42533673Full record

ArticleBrain and behavior2026

Early Upper Limb Motor Impairment in Multiple Sclerosis Across EDSS Levels: A Case-Control Study.

Aitor Blázquez-Fernández, Selena Marcos-Antón, Cecilia Estrada-Barranco, Patricia Martín-Casas, Rosa María Ortiz-Gutiérrez, Carmen Jiménez-Antona, Sofía Laguarta-Val, Roberto Cano-de-la-Cuerda

Abstract read
In one paragraph

Article in Brain and behavior, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Aitor Blázquez-FernándezInternational PhD School, Rey Juan Carlos University, Madrid, Spain.
Selena Marcos-AntónFaculty of Health Sciences, Universidad Villanueva, Madrid, Spain.
Cecilia Estrada-BarrancoDepartment of Physical Therapy, Universidad Europea de Madrid, Madrid, Spain.
Patricia Martín-CasasDepartment of Physical Therapy, Complutense University, Madrid, Spain.
Rosa María Ortiz-GutiérrezDepartment of Physical Therapy, Complutense University, Madrid, Spain.
Carmen Jiménez-AntonaFaculty of Health Sciences, Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Rey Juan Carlos University, Madrid, Spain.
Sofía Laguarta-ValFaculty of Health Sciences, Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Rey Juan Carlos University, Madrid, Spain.
Roberto Cano-de-la-CuerdaFaculty of Health Sciences, Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Rey Juan Carlos University, Madrid, Spain.

Funding

The project has been funded through a competitive call, specifically the 6th Research Grant Call awarded by the Illustrious Professional College of Physiotherapists of the Community of Madrid (Spain). 1-10-2025
6 · The paper itself

Abstract

backgroundUpper limb (UL) involvement is common from the early stages in people with multiple sclerosis (PwMS) and has a significant impact on daily activities, quality of life, and autonomy. However, it may be underestimated by the Expanded Disability Status Scale (EDSS).

aimThe objective of this study was to determine differences in UL function between PwMS, stratified by EDSS ≤3.5 and >3.5, and healthy controls (HCs), as well as between PwMS subgroups according to EDSS score.

methodsA case-control study was conducted following STROBE guidelines. Participants with MS were stratified into two groups on the basis of disease severity (EDSS ≤3.5 and >3.5). UL function was assessed using the hand grip strength (HGS) test, Box and Block Test (BBT), Nine-Hole Peg Test (NHPT), and ABILHAND questionnaire. Additionally, fatigue and disease impact were evaluated using the Fatigue Severity Scale (FSS) and the Multiple Sclerosis Impact Scale 29 (MSIS-29). HCs were assessed using the HGS test, BBT, and NHPT.

resultsPwMS (n = 69; median age 49 years [interquartile range-IQR 13]; 66.7% female; 34 relapsing-remitting MS, 21 secondary progressive MS, and 14 primary progressive MS; median EDSS 6.0 [IQR 2.5]) showed significant impairments in all objective UL measures compared with HC (n = 23; median age 44.5 years [IQR 32]; 56.5% female), even at low levels of neurological disability. Differences between EDSS subgroups were observed in BBT and NHPT for the more affected UL, whereas no significant difference was found for the HGS test. For the less affected UL, only NHPT differed significantly between EDSS subgroups. No statistically significant differences were found between EDSS subgroups for ABILHAND, FSS, or MSIS-29.

conclusionsThese findings suggest that EDSS alone may not adequately capture UL dysfunction. The use of objective, sensitive, and validated assessments is essential to detect UL deficits, including subtle impairments, from early stages of MS, supporting the need for a multidimensional approach to UL disability assessment.

Indexed as

Multiple SclerosisUpper ExtremityAdultCase-Control StudiesDisability EvaluationFatigueFemaleHand StrengthHumansMaleMiddle AgedSeverity of Illness IndexassessmentExpanded Disability Status Scale (EDSS)functionalitymultiple sclerosisupper limb

Identifiers

PMID42533673
PMCPMC13425605

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.