Association of Upper Limb and Gait Performance With Basic and Instrumental Activities of Daily Living in Patients With Multiple Sclerosis

Objective This study aimed to examine the associations between objective functional performance tests, clinical disability, MRI lesion characteristics, and recent relapse activity with basic and instrumental activities of daily living (ADLs/IADLs) in people with multiple sclerosis (MS). Materials and methods In this cross-sectional study including 65 patients with MS, clinical disability was assessed using the Expanded Disability Status Scale (EDSS), while functional performance was evaluated with the Timed 25-Foot Walk test (T25FW) and the 9-Hole Peg Test (9-HPT). Functional independence was assessed using the Barthel Index for basic ADL and the Lawton IADL scale. MRI lesion characteristics and relapse activity during the preceding two years were recorded. Associations were analyzed using Spearman correlation and multivariable linear regression models. Results Higher EDSS scores and worse T25FW and 9-HPT performance were associated with lower Barthel and IADL scores. In adjusted models, T25FW remained independently associated with basic ADL, while non-dominant hand 9-HPT was the strongest independent predictor of IADL; EDSS showed a weaker independent association with IADL. MRI lesion variables and recent relapse activity were not independently associated with functional independence. Conclusions Simple performance-based measures of gait speed and upper limb dexterity are strongly associated with real-life functional independence in MS and may contribute to a more comprehensive functional assessment in routine clinical practice.