Action Research Arm Test (ARAT) in MS [AR(MS)]

The purpose of the project is to address the following objectives:

  • This study is being done because at the moment, while there are a number of available tools to assess upper limb mobility; upper limb assessment in persons with multiple sclerosis (MS) is limited. Previous studies have shown inconsistencies in the relationship between measures on activity levels and impairments on body function and structures (e.g., muscle weakness, spasticity, impaired coordination, and sensory function). The aim of the study is to evaluate whether three upper limb specific measures; Upper Extremity Functional Scale (UEFS), Action Research Arm Test (ARAT), and the 9 Hole Peg Test (9-HPT) analyzed in conjunction with the MS Quality of Life (MS QoL-54) and the Timed 25-Foot Walk can be used to provide the most accurate and representative level of activity. If these measures, together, give an accurate representation of the level of activity in persons with MS, then targeted, appropriate, physical therapy can be implemented. Thus, improving the quality of life in persons with MS.

You will be asked permission to:

After you have given your consent to participate in the study, a number of activities will take place.  This study is assessing the effectiveness of four tools in measuring your upper limb mobility.  Participating in this study will take approximately an hour in total and will take place in Saskatoon City Hospital. The tools are described in detail below:

3 Upper extremity specific measures:

  • Upper Extremity Functional Scale (UEFS):8 Item Questionnaire(less than 5 minutes)
    • A region-specific questionnaire developed to assess the outcome of work-related upper extremity disorders. This scale is a patient-filled questionnaire measuring the functional component of physical health. The item responses were on a 1–10 response scale
  • Action Research Arm Test (ARAT) (10 minutes)
    • 19 item assessment of upper limb functioning using observational methods
    • Measure divided into 4 sub-tests (grasp, grip, pinch, and whole arm movement).
  • 9 Hole Peg Test (10 minutes)
    • The 9-HPT is a brief, standardized, quantitative test of upper extremity function. Both the dominant and non-dominant hands are tested twice. The participant is seated at a table with a small, shallow container holding nine pegs and a wood or plastic block containing nine empty holes. On a start command when a stopwatch is started, the participant picks up the nine pegs one at a time as quickly as possible, puts them in the nine holes, and, once they are in the holes, removes them again as quickly as possible one at a time, replacing them into the shallow container. The total time to complete the task is recorded. Two consecutive trials with the dominant hand are immediately followed by two consecutive trials with the non-dominant hand.

Timed 25-Foot Walk:

  • The T25-FW is a quantitative mobility and leg function performance test based on a timed 25-walk. The participant is directed to one end of a clearly marked 25-foot course and is instructed to walk 25 feet as quickly as possible, but safely. The time is calculated from the initiation of the instruction to start and ends when the participant has reached the 25-foot mark. The task is immediately administered again by having the participant walk back the same distance. Participants may use assistive devices when doing this task.

Quality of life Measure:

  • MS Quality of life (MS Qol-54) (11-18 minutes)
    • The MSQOL-54 is a multidimensional health-related quality of life self-report questionnaire that combines both generic and MS-specific items into a single instrument. (Vickrey et al, 1995) (Vickrey et al, 1997) This 54-item questionnaire asks about: physical function, physical and emotional role limitations, pain, emotional well-being, energy, health perceptions, social function, cognitive function, health distress, overall quality of life, and sexual function. You do not have to answer any questions to you feel uncomfortable with.

In addition to these tasks, if you are, or become, a patient in the Saskatoon MS Clinic, we request your permission to link your clinical data from your Saskatoon MS Clinic chart to the study data. This data may also be linked with health data that the government already collects, related to your use of the health care system.

Data - Multiple Sclerosis Epidemiology and Health Outcomes in Saskatchewan

The purpose of the project is to address the following objectives:

  1. Identify factors that affect or influence MS over time
  2. Determine how effective the MS treatments are over time
  3. Determine how individuals with MS in Saskatchewan use the health care system and what the costs to health care system are
  4. Determine the quality of life for individuals living with MS in Saskatchewan.

You will be asked permission to:

  1. Data will be collected from your medical chart from the MS Clinic. This data may also be linked with health data that the government already collects, related to your use of the health care system. For example; MRIs, blood tests related to MS or other neurological condition(s), and information conserning hospital visits/stays.
    • We will also give you the option to consent to having your de-identified data included in an international data registery called MSBase.
  2. You may be asked to complete two or three questionnaires during your clinic appointment, depending on the time available. The first is a short questionnaire called the Health Utility Index (HUI). The HUI has 16 questions that ask information about your quality of life. The second questionnaire is called the Godin Leisure-Time Exercise Questionnaire (GLTEQ). The GLTEQ is a short survey to assess your physical activity level. The third questionnaire is called the Multiple Sclerosis Quality of Life-54, which consists of 54 questions which also ask about your quality of life. If you are uncomfortable with any of the questions in either the HUI, GLTEQ, or the MSQoL-54, you do not need to answer them.
  3. Contact you again and invite you to participate in future research studies for which you may be eligible.

Blood Draw - Multiple Sclerosis Epidemiology and Health Outcomes in Saskatchewan

The purpose of the project is to address the following objectives:

  1. Identify factors that cause, affect or influence MS over time
  2. Determine how effective the MS treatments are over time
  3. Determine how individuals with MS in Saskatchewan use the health care system and what the costs to health care system are
  4. Determine the quality of life for individuals living with MS in Saskatchewan.
  5. Test immune cells and their contents taken from blood samples of people with MS and examine them in relation to 1-4 above.

 You will be asked permission to:

After you consent to participate in this study, we will contact you to arrange a time for you to come back to the Saskatoon City Hospital and get your blood sample taken. 

  1. Providing a blood sample for biomarker testing, which includes the following (DNA, RNA, protein, lipid and antibodies) and is desbribed in more detail below. A biomarker is a substance in your blood that may help diagnose MS in others, or predict how MS will worsen over time.
    • If you are also a patient in the Saskatoon MS Clinic, who has consented to participate in the data portion of this study, your blood sample results will be linked to your de-identified patient data via a coded participant ID (i.e., 139-0001, 139-0002, etc.).
  2. Contact you again and invite you to participate in future research studies for which you may be eligible.

Saskatchewan MS Drugs Research Program

The primary purpose of this research is to:

  • Describe drug utilization patterns for persons with MS in SK (including understanding the number of people who are not on any treatment)
  • Describe the direct costs associated with MS disease-modifying drugs in Saskatchewan.
  • Examine relationships between treatment with MS drugs and other diseases (co-morbidities), health-related quality of life and other clinical outcomes, such as disability progression, relapse rates, hospital and physician visits, complications, side effects and function.